Isolated Hepatic Perfusion Treatment

Doctors treat some inoperable cancers with isolated hepatic perfusion (IHP). UPMC Hillman Cancer Center is one of only a few cancer centers in the U.S. where surgeons use this technique.

What Is Isolated Hepatic Perfusion (IHP) Treatment?

IHP is an innovative treatment for some liver cancers when doctors can't remove tumors with surgery. It's one of many liver cancer treatment options at UPMC.

Surgery is often the best way to treat early-stage liver cancer. But when the cancer is advanced, surgery may not be an option. Likewise, regular chemotherapy may not be effective in treating liver cancer.

With IHP, the team of experts at UPMC can tackle liver cancer that doesn't respond to other treatments. This therapy combines heat and the direct application of chemo drugs to kill cancer cells without affecting nearby organs or tissue.

How does IHP treatment differ from regular chemo?

In traditional chemo, people receive cancer-killing drugs through an IV or by mouth. While these drugs kill the cancer cells, they may also harm healthy cells in the body.

With IHP, doctors apply high doses of heated medicine to just one area — the liver — leaving healthy tissue unharmed. The heated medicine and blood circulate through the liver for about an hour, bathing the cancer in chemo drugs.

By separating the liver's circulatory system from the rest of the body, doctors ensure the chemo doesn't hurt healthy organs.

Who's a good candidate for IHP treatment?

If you have certain inoperable liver cancer, but are otherwise in good health, IHP might be right for you.

To help decide, doctors will look at many factors, such as:

The exact location of the cancer.
Other health conditions you might have.
Your surgical history.
Your physical strength.

Isolated Hepatic Perfusion Treatment Benefits and Risks

IHP is the right treatment for some, but not all, people with liver cancer. The experts at UPMC Hillman Cancer Center can look at your case and tell you if IHP is an option for you.

As with any complex procedure, there are pros and cons.

Doctors can apply chemo treatment directly to tumors without killing healthy cells elsewhere in the body.
IHP delivers a high concentration of chemo right to the liver, making it more effective than regular chemo.
IHP may be the best option for people with inoperable liver cancer.
Heating cancer cells to above-normal temperatures makes them easier to destroy with certain chemo drugs.

IHP requires special equipment and a highly trained treatment team.
It's a long, complex procedure that requires a large incision and open surgery in an operating room.
Side effects may include nausea, vomiting, and diarrhea.
Rare side effects can include problems with the heart, blood vessels, and other major organs.

Cancers We Treat With Isolated Hepatic Perfusion

Doctors may use IHP to treat some liver cancers (e.g. colorectal liver metastases and melanoma in the liver).

Surgery is often the best method for removing early-stage liver cancer but may not be an option for more advanced cancers.

Because standard chemo isn't effective in treating liver cancer, IHP can sometimes be a better option.

Metastases, or secondary cancers, start in one part of the body and spread to another organ or organs.

Like primary liver cancers, some secondary liver cancers are too advanced to remove with surgery. If the secondary cancer hasn't spread beyond the liver, IHP may be an option.

Melanoma is a skin cancer that spreads through the bloodstream to another part of the body. Some melanomas stay in one organ, such as the liver.

IHP is a treatment option for these tumors if doctors can't remove them with surgery.

What Can I Expect During Isolated Hepatic Perfusion?

IHP is a complex treatment that takes hours to complete. Here's what to expect before, during, and after the procedure.

As with any surgery, you won't be able to eat or drink anything after a certain time the night before. Your doctor will give you instructions about taking your other medications.
At the hospital, your care team will start an IV and place you under anesthesia. The procedure takes place in an operating room under general anesthesia, which means you'll be asleep.

The surgeon makes a large cut in the belly to expose the inner organs and tissues.
They clamp the veins and arteries leading to and away from the liver. The clamps separate the circulatory system of the liver from the rest of the circulatory system. They also prevent the chemo medicine from leaking into other organs and tissues.
The doctor then inserts a catheter tube in two places to take the blood out and put the chemotherapy medicine in.
The surgeon secures the catheter in both places to create a circuit. They connect it to a pump, which heats the chemo solution.
The heated chemo solution circulates continually into and out of the liver for about an hour.

Doctors will send you to the recovery room. Your recovery time will depend on a few factors, including how sick you are. You may need to spend a week or two in the hospital after the treatment.
Once you go home, the cancer care team will follow up with you as you heal from the surgery. They'll give you specific instructions on scheduling follow-up visits. They'll also set you up with specialists in nutrition, pain management, and mental health.
Expect to feel more tired than usual for a few months as your body recovers from the surgery.

More Treatment Options for Liver Cancer

Contact Us About Regional Perfusion Cancer Treatment

Surgeons see Koch Center patients at UPMC Hillman Cancer Center in Shadyside.

To learn more about regional perfusion therapy, contact the David C. Koch Regional Perfusion Cancer Therapy Center. Or call UPMC Hillman Cancer Center at 412-692-2852.