ABSTRACT
Primary hepatic malignancy is more common in patients with cirrhosis, especially viral-induced liver disease and non-alcoholic fatty liver disease (NAFLD), and may be best treated by transplantation when advanced liver disease precludes liver resection because of the risk of postoperative liver failure or when the tumour is multifocal as a result of field changes in the cirrhotic liver that predispose to recurrence or further primary malignancies. Potential candidates undergo a comprehensive multidisciplinary assessment, including hepatologists, transplant surgeons, anaesthetists, specialist nurses in liver transplantation (LT), drug and alcohol rehabilitation services, dietician, psychologists and specialists from other clinical disciplines where indicated. After total hepatectomy the implantation starts by placing the liver graft in the orthotopic position. Auxiliary LT involves implanting a healthy liver graft placed either heterotopically or orthotopically while leaving all or part of the native liver intact.
