Current evidence on ex-vivo hepatic resection and reimplantation for liver cancer raises concerns about the safety and efficacy of the procedure. Therefore, this procedure should only be used with special arrangements for clinical governance, consent and audit or research. It should only be used for patients who would otherwise not survive and for whom other treatment options have failed or are inappropriate.
Clinicians wishing to undertake ex-vivo hepatic resection and reimplantation for liver cancer should take the following actions.
Inform the clinical governance leads in their Trusts.
Ensure that patients understand the uncertainty about the procedure's safety and efficacy; specifically the risks of death or serious morbidity, and the possible need for liver transplantation. Clear written information should be provided. In addition, the use of NICE's information for the public is recommended.
Audit and review clinical outcomes of all patients having ex-vivo hepatic resection and reimplantation for liver cancer (see section 3.1).