Bridging therapy with histotripsy prior to liver transplantation for hepatocellular carcinoma: a first case report
Melis Uysal, Chase J. Wehrle, Christopher Coppa, Suneel Kamath, Smitha Krishnamurthi, Charles E. Martin, Mohamed El Hag, Mazhar Khalil, Masato Fujiki, Andrea Schlegel, Charles C. Miller, Koji Hashimoto, Federico Aucejo, David CH Kwon, Jaekeun Kim
Abstract
BACKGROUND: Histotripsy is a novel, non-invasive, non-ionizing, and non-thermal ablation technique that disrupts tumors using acoustic cavitation. We report the first use of Histotripsy as bridging therapy prior to liver transplant for hepatocellular carcinoma (HCC) treated with histotripsy. CASE PRESENTATION: A 59-year-old woman presented with Metabolic-Associated Steatotic Liver Disease (MASLD) cirrhosis (labMELD = 14), hepatic encephalopathy, and a single 2 cm OPTN V lesion in the left lateral segment consistent with HCC. The patient underwent histotripsy treatment of the lesion as bridging therapy before receiving liver transplantation. Histopathology analysis of the explanted liver showed total necrosis of the treated area, with no residual viable tissue tumor. CONCLUSION: This case demonstrates the potential utility of histotripsy as an effective bridging therapy for patients with combined cirrhosis and hepatocellular carcinoma (HCC) awaiting liver transplantation, with complete tumor necrosis on explant pathology demonstrating its therapeutic efficacy.