British Liver Trust

Hcc and tace

My husband had ablation last may seen consultant yesterday to ger MRI results two small tumours 3cm have appeared dr said because he had heart attack 2 and a yrs ago mightnt be candidate for transplant but sending him to see cardiologist already had echocardiogram has moderate left ventricle damage in the meantime they may do TACE he was getting ascites drains but since increase in water tabs doesnt need drain dr also mentioned a drug trial taking place with nivolumab.

My question is has anybody out there been refused transplant after heart attack and has anybody had TACE to treat HCC.

Thank you karen x

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I regularly have had TACE as part of liver management. Initially it was used to keep my tumours small enough in both number and size whilst I waited on the “transplant list”. I eventually got “the call” but the transplant was aborted due to a major haemorrhage and thus transplantation is no longer an option. I have had 9 separate embolisations so far and expect to be in double figures sometime soon. The procedure I find painless and is performed under local anaesthetic. It involves inserting a CT guided tube through the femoral artery to the offending tumour and spreading the “magic dust” wherever the said tumour is getting its blood supply from. Once completed you must lie flat for about 6 hours and would ordinarily be discharged the following morning with a small plaster over the puncture wound. You would then feel not 100% for a few days and then return for another scan in 2-3 months to gauge the success and see if you need the procedure repeated at any point. I had my scans this week and will be seeing my consultant next week to discuss/gauge the success of the procedure I had in December.

I understand the issues around transplantation and previous heart attack, and this will ultimately be critical in any decision to put your husband on the list.

A liver transplant is a massive operation and his survival is of paramount importance. If his heart can withstand the pressure it will be placed under he will be added, if it won’t he will not be added.

The importance of the strength of the heart is the only reason I am still here to write this reply to you. I underwent the transplant procedure but it was aborted due to a major haemorrhage. I required 25 pints of blood, something a normal liver would struggle to process, a diseased liver should not. I was in a coma for 12 days and twice my family were told to “ prepare themselves” for the inevitable. The pressure my heart came under was immense but it was strong enough to keep pumping and I am here to tell the tale. During the testing for transplant suitability they stress test the heart, imagine my surprise when they told me I had the heart of a 21 year old, I was 54/55 at the time, overweight and the only part of me that was functioning better than should have been expected was my heart.

I have written a blog about my cancer journey and having had 9 embolisations so far they get plenty of mentions and may just give both you and your husband something tangible to help you get your head around.

If you have any questions please just ask.

My blog is at 1liver1life.wordpress.com

Ray

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Thank you ray for replying. I wasnt aware you could have more than one TACE you have been throught a lot amazing journey. Consultant said my husband is borderline so hopefully if he cant have transplant they will give him TACE thank you

Karen

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Something was nagging at my brain, I am unsure whether I have had TACE or something else. I undergo a procedure that does the same thing without the use of any Chemotherapy. The purpose is to cut off the blood supply to the tumours and this has been quite successful. I know that they were talking about TACE at the beginning and I just assumed that is what is being used. My mistake and I am sorry if you feel I have misled you, it was an innocent error on my part. It may be something to discuss as I am sure Chemo will kill off larger amounts of good liver, should transplant not be deemed suitable.

Ray

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It might be SIRT that you have george has cirrhosis but reading about TACE i think you can have it a number of times so it may well be TACE but thank you for your reply. if you dont mind me asking what hospital are you under karen

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I am under The Royal Free, I am seeing my Professor on Thursday and I will ask. Regardless it is an effective treatment and relatively painless. It’s the anxiety before the first time when everything is “the unknown” that is far worse than the procedure itself. Now I know every consultant radiologist by name as they have all worked on me at some point. Onwards and Upwards.

Ray

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Ahh thank you and yes you are quite right it is the "not knowing" thats worrying. George is under aintree hosp liverpool they are supposed to be the heptobilliary centre for north west so they are pretty good and consultants and staff are lovely. Good luck for thursday and if you could let me know if it is tace thank you so much karen

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