Saturday, November 18, 2017
Health

Rare liver surgery performed at TGH saves Tampa man's life

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When doctors learned during surgery that Ken Brant's liver was too riddled with cancer for a conventional procedure, they turned to his wife with two options.

Do nothing, and see him survive maybe six to eight months.

Or consent to a risky surgical procedure so rare it had never been done before at the hospital, Tampa General, and had only been performed about 500 times anywhere in the world.

It involves cutting this largest of the internal organs in two and isolating the cancerous portion so the healthy portion can regenerate. If successful, it would cure Brant of liver cancer.

Jeanne Brant said her on-the-spot decision was easy. The surgery, though, was anything but.

"This is an operation when basically there is no hope for other operations," said surgeon Julio Sokolich, part of TGH's transplant team. "It requires a high level of skills."

On Wednesday, Ken Brant appeared at a hospital news conference to tell his remarkable tale of survival.

Brant, 67, a retired service representative for Colgate-Palmolive, knew before undergoing surgery that there was a chance doctors would have to turn to his wife later with the risky surgery option. Still, he said, he was never concerned.

"It's surreal to me because in my own mind I never, ever, thought I wouldn't survive," he said. "Until later on when I kind of looked back and realized how major this turned out to be."

Officially, the procedure is called, "Associating Liver Partition and Portal Vein Legation for Staged Hepactectomy."

Sokolich calls it extreme liver surgery.

The liver can regenerate, so removing the cancer-stricken portion is a common option.

A patient can have up to 80 percent of the organ cut out and survive.

Doctors hoped Brant would fall within this range.

But they found that the cancer had spread just a bit too far, across 84 percent of his liver.

So they split his liver in two pieces, keeping them connected via the bile duct and hepatic artery.

Then they divided the hepatic artery so nutrients only flowed to the healthy portion of the liver, allowing it to increase in size as the sick part shrank.

They performed the surgery Feb. 28. Two weeks later, the healthy part grew to 26 percent of the total liver — allowing for the removal of the cancerous side.

Just over two weeks later, Brant was back at his South Tampa home.

The chance of dying from the surgery is high, about 30 percent, so few surgeons are willing to attempt the procedure, Sokolich said.

"We provide care for people who have the simplest liver conditions to the most complicated," said Angel Alsina, director of liver transplantation at TGH.

Brant's liver now has regenerated to 45 percent of its former size and will reach 70 to 80 percent — enough to keep him healthy, Sokolich said.

This is Brant's second bout with cancer. In 2011, he was diagnosed with colon cancer and the tumor was successfully removed.

Then in December he learned he had colorectal liver cancer — when colon cancer spreads to the liver.

Some liver cancer patients can receive a transplant. TGH has performed an average of 97 of them per year since 2007, according to its website, ranking it in the top 10 nationwide.

Brant was not a candidate because his cancer carries a high risk of invading the new liver, Sokolich said.

Brant is driving again and looks forward to getting back to his favorite hobbies of bike riding and golf. Doctors say his prognosis is good.

"Mr. Brant can go through a normal life with no problem," Sokolich said. "And he is basically cancer-free at this moment."

Contact Paul Guzzo at pguzzo@tampabay.com. Follow @PGuzzoTimes.

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