Liver Transplantation for Giant Hepatic Hemangioma: A Systematic Review

Introduction. Despite their benign nature, liver hemangiomas (LH) are lesions that can cause major complications requiring intervention. Liver transplantation (LT) has been suggested as an effective treatment option in selected patients with giant LHs causing severe symptoms and cannot be treated otherwise. The aim of our study was to investigate the indications, aspects and post-operative outcomes of patients with a LH who underwent LT. Materials and methods. A meticulous search of the literature was performed. Studies presenting cases of LT due to LH were evaluated. Studies presenting patients characteristics and symptoms, aspects of the disease, transplantation indications and details were selected. Results. Fifteen studies were included in the present review that involved 16 patients. Among them, 4 were male while the remaining 12 were female with a mean age of 39.9 +/- 8.7 years. The main indications for LT included respiratory distress, massive hemorrhage, Kasabach-Merritt syndrome, and unsuccessful previous treatment strategies. Four patients were transplanted from living donors and the remaining 12 from cadaveric donors. No post-operative deaths were reported and all patients returned to normal activity. No deaths during the long-term follow-up were reported. Conclusions. LH is an extremely rare indication for LT. Nevertheless, the currently available data suggest that LT is a safe and efficient treatment in the management of symptomatic or complicated LH in selected patients.