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For the approximately 3,000 patients who are diagnosed with advanced cancer of the bile ducts, the tubes that carry bile from the liver to the gallbladder, options are usually limited to chemotherapy and palliative care. Now, NewYork-Presbyterian Hospital/Columbia University Medical Center is one of the first hospitals anywhere to offer liver transplantation for these patients, giving them new hope for keeping their cancer at bay. The first two cases, one with the organ donated from a living donor and one by deceased donor, have been successful, with the patient healthy with no evidence of cancer.

Available as part of an ongoing clinical research trial at NewYork-Presbyterian Hospital/Columbia University Medical Center, the transplantation procedure is commonly done using a living donor—usually the patient's family member, who donates part of their liver, which is then transplanted into the patient once their diseased liver is removed. Within a few weeks, the healthy donor's liver regenerates to full size with no long-term impairment of liver function. The transplanted liver portion also regenerates to normal size for the recipient. Advantages include greater flexibility for chemotherapy treatment and possibly a reduced risk of organ rejection.

"Before this innovative treatment became available, these patients had no curative options if the cancer was not operable. Liver transplantation gives patients with cancer of the bile ducts a new chance at life," says Dr. Robert Brown, chief of abdominal organ transplantation and director of the Center for Liver Disease and Transplantation at NewYork-Presbyterian/Columbia and associate professor of medicine and surgery at Columbia University College of Physicians and Surgeons. "Traditionally, liver transplantation for small liver cancers has been fairly straightforward, but bile-duct cancer was not possible due to high rates of recurrence after transplant. Recent research has discovered a successful approach using radiation and chemotherapy prior to transplantation. We have modified this protocol in order to open the procedure to a greater number of non-metastatic patients and to eliminate the need for 'second-look' operations."

"This procedure combines advanced techniques in liver surgery with those of transplantation," says Dr. Jean Emond, chief of transplantation at NewYork-Presbyterian/Columbia and professor and vice chairman of surgery at Columbia University College of Physicians and Surgeons.

Previous research published in the peer-reviewed journal Liver Transplantation (May 2000) has shown encouraging results. Initial survival rates are similar to survival rates after liver transplants for other disorders. In most cases, the treatment was curative.

For very small tumors, surgical removal (resection) of part of the bile duct is possible. Without surgery, it is a rapidly fatal disease with five-year survival rates of less than 5 percent. The most common symptom of the cancer is jaundice (yellowing of the eyes and skin), which occurs when bile ducts are blocked by the tumor. Other common symptoms include generalized itching, abdominal pain, weight loss and fever.

For more information, patients may call 866-NYP-NEWS.

NewYork-Presbyterian Hospital

NewYork-Presbyterian Hospital—based in New York City—is the nation's largest not-for-profit, non-sectarian hospital, with 2,224 beds. It provides state-of-the-art inpatient, ambulatory and preventive care in all areas of medicine at five major centers: NewYork-Presbyterian Hospital/Weill Cornell Medical Center, NewYork-Presbyterian Hospital/Columbia University Medical Center, Morgan Stanley Children's Hospital of NewYork-Presbyterian, NewYork-Presbyterian Hospital/Allen Pavilion and NewYork-Presbyterian Hospital/Westchester Division. One of the largest and most comprehensive health-care institutions in the world, the Hospital is committed to excellence in patient care, research, education and community service. It ranks sixth on U.S.News & World Report's guide to "America's Best Hospitals," has the greatest number of physicians listed in New York magazine's "Best Doctors" issue, and is included among Solucient's top 15 major teaching hospitals. The Hospital has academic affiliations with two of the nation's leading medical colleges: Joan and Sanford I. Weill Medical College of Cornell University and Columbia University College of Physicians and Surgeons.

Columbia University Medical Center

Columbia University Medical Center provides international leadership in pre-clinical and clinical research, in medical and health sciences education, and in patient care. The medical center trains future leaders and includes the dedicated work of many physicians, scientists, nurses, dentists, and public health professionals at the College of Physicians and Surgeons, the Mailman School of Public Health, the College of Dental Medicine, the School of Nursing, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. For more information, visit www.cumc.columbia.edu.