Isolated hepatic perfusion with extracorporeal oxygenation using hyperthermia, XXXX necrosis factor alpha and melphalan.

@entity1 @entity137 @entity548 @entity5 @entity310 @entity409 @entity1003 @entity3601 @entity1822 @entity14 @entity881 @entity320
AIMS: To determine the @entity137 and efficacy of isolated hepatic perfusion with @entity5 necrosis factor alpha ( @entity310 ) and melphalan (Alkeran) under mild hyperthermic conditions. METHODS: A phase I trial was performed. Eleven @entity1 with unresectable metastatic @entity409 were pre-treated with 3 x 10(6) U leukocyte IFN daily 2 days before the perfusion. The liver was isolated and inflow catheters inserted in the hepatic artery and the portal vein. The hepatic veins were drained via a catheter in the retrohepatic caval vein. The venous blood flow from the lower extremities and the splanchnic circulation was bypassed to the axillar vein. The liver circuit was perfused with oxygenated blood and 30-200 microg @entity310 was added. At 39 degrees C in the liver circuit 0.5 mg/kg @entity3601 was added and the perfusion was continued for 1 h. RESULTS: Six @entity1 underwent re-operation due to @entity548 . Two @entity1 died of @entity1003 or @entity881 within the first post-operative month. Three of six @entity1 with liver metastases from @entity320 or @entity1822 showed a partial response while no @entity1 with liver metastases from @entity14 showed any response. The mean survival time was 20 months, which is within the same range as seen in previous isolated hepatic perfusion (IHP) studies. CONCLUSIONS: IHP with this drug regimen is a method with a considerable @entity137 , though it is hard to distinguish between @entity137 from @entity310 and that from the perfusion procedure itself. The method was not effective in @entity1 with @entity14 , but the results in @entity320 and @entity1822 @entity1 warrant further studies.
