Liver Cancer Transplant

Andrew, 40 years old, Bolton

Andrew was first investigated at his local Hospital for abdominal pain. Hepatitis C (contracted abroad) was diagnosed following a liver biopsy. He was transferred to a Consultant Hepatobiliary Surgeon at a nearby specialist Hospital and a subsequent scan showed “a moderate degree of chronic hepatitis and fibrosis consistent with hepatitis C virus infection”.

A further liver scan performed the next year showed that cancer of the liver had developed. As Andrew was relatively young and not thought to have cirrhosis he was considered to be a good candidate for liver resection, although he was informed that he may require a liver transplant in the future.

Andrew underwent a resection despite the fact that once the liver was visualised it was realised that there was in fact a degree of cirrhosis present. The reason the cirrhosis had not been picked up on the earlier biopsy was because the disease was patchy rather than consistent throughout the liver and the biopsy had taken a sample from an unaffected patch of tissue, known as a sampling error.

The key issue in deciding whether to operate for cancer of the liver is whether the amount and quality of liver left behind after removal of the tumour will be sufficient to maintain the patient’s health and prevent liver insufficiency and failure. Therefore, patients with major liver damage will not usually tolerate liver resection. Andrew’s liver damage was considered to be severe.

Within a month it was clear that Andrew’s liver was failing and he was transferred to a regional specialist hospital. Andrew’s condition was critical with severe liver insufficiency and an abdominal infection. Once the infection was controlled his only hope of survival was a liver transplant and by good luck a liver became available the day after he was placed on the waiting list.

Unfortunately there was bleeding during the operation and the decision was taken to use mechanical portal bypass in an attempt to control this. A small air embolus entered the system when a clamp fell off and this was the final straw for Andrew who was already critically ill. All attempts at resuscitation failed.

JMW Solicitors alleged that when it was discovered at the initial operation that Andrew’s liver was cirrhotic, the operation should have been abandoned because of the poor prospect of a successful outcome. It was argued that instead of proceeding with the liver resection Andrew should have been placed on the priority transplant list immediately. If this has happened Andrew would have recovered well from the surgery and survived for at least 5 to 10 years.

£50,000 compensation was awarded to Andrew’s wife and daughter.