The Houston Methodist J.C. Walter Jr. Transplant Center is making major strides in the field of liver transplant oncology, as highlighted in a new video featuring the physicians, transplant surgeons and robotic surgery experts leading the advancements in the treatment of complex liver disease.

The roundtable discussion, led by Dr. Mark Ghobrial, director of the Walter Transplant Center, showcases the integrated efforts of surgeons, hepatologists and oncologists to address liver cancer, a significant and growing health burden.

Dr. Sudha Kodali, medical director of the Liver Tumor Program at Houston Methodist, notes the increasing prevalence of liver cancer, particularly in Texas and other states in the South, due to conditions like fatty liver disease and metabolic syndrome.

Robotic surgery plays a pivotal role in making living donor liver transplant procedures more accessible for patients with refractory liver tumors, says Dr. Yee Lee Cheah, director of the Robotic Living Donor Liver Transplantation Program at Houston Methodist, emphasizing the benefits of robotic techniques, including reduced pain, shorter hospital stays and potentially fewer complications.

"Robotic surgery is more challenging for surgeons but much better for patients," Dr. Cheah states, noting that healthy donors are voluntarily putting their lives on the line to offer a loved one a chance at a longer life. "We owe it to these selfless individuals to make their role in this as safe and easy as possible."

Beyond the technical advances in the procedures, the team is pushing the boundaries of traditional transplant criteria for liver cancer patients.

Dr. Constance Mobley, associate director of the Liver Transplant Program and director of the Liver Transplant ICU, explains how Houston Methodist assesses transplant eligibility based on tumor biology, not just tumor size, enabling treatment of patients previously deemed ineligible.

This approach, combined with tailored protocols and therapies, has resulted in survival rates comparable across varying tumor sizes, with five-year survival reaching 60% for complex cases, significantly higher than the current 20% survival rate for resection and chemotherapy alone.

The center is also utilizing machine perfusion technology to expand liver availability, significantly increasing the number of transplants from donors after cardiac death.

"Our multidisciplinary approach is key," says Dr. Kodali. "We work across specialties to deliver personalized care, often for patients referred after exhausting other options."

Dr. Ghobrial emphasizes the importance of educating physicians nationwide on the widening scope of transplant oncology and the advances in liver cancer evaluation and treatment at Houston Methodist.

"Most people believe that liver transplant oncology is restricted to a certain small number of patients with small tumors, but that isn't the case anymore," he says.

The roundtable participants conclude by inviting physicians to refer patients early for optimal outcomes, while also emphasizing that it's never too late to get a second, third or fourth opinion.

"If you have a patient with a liver tumor, and you've reached the end of the road as far as what you're able to do for them, we are always willing to take a look to see if there's something else we can offer," says Dr. Mobley.

Although a transplant can never be guaranteed, Dr. Kodali echoes Dr. Mobley's sentiments. "We are aggressive in a great way, and we will try whatever we can to get the patient to transplant while still paying attention to outcomes and always doing what's right for the patient," she says.

Click on the image above to hear the full discussion and learn more about how transplantation is transforming liver cancer treatment at Houston Methodist and beyond.