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Although hepatic artery infusion (HAI) chemotherapy has been an available modality to treat disseminated liver malignancies for several decades, there has been growing interest in HAI chemotherapy over the past several years (Ko and Karanicolas, Curr Oncol 21(1):e116–e121, 2014).While HAI was historically limited to a small number of highly specialized centers, new HAI programs have been gradually opening as more institutions gain interest in offering HAI as a potential treatment option for this complex subset of patients (Creasy et al., Ann Surg Oncol 27(13):5086–5095, 2020; Walker et al., J Surg Oncol 126(3):513–522, 2022; Muaddi et al., J Surg Oncol 123(1):252–260, 2021).The HAI Consortium Research Network (HCRN) was established in 2020, serving as a collaborative to facilitate research and collect data to analyze the safety, feasibility, and efficacy of HAI programs. While many new HAI programs that were developed over the last 20 years were found to be unsustainable and subsequently dissolved (Cavnar et al., HPB (Oxford) 24:S100, 2022), the HCRN currently has nearly 80 participating hospitals from around the world and new programs have more recently exhibited greater success. The most important phase impacting the success of a new HAI program is during its initial establishment and early experience. In this chapter, we discuss considerations prior to establishing a program, considerations for building a successful program, early patient selection, surgical planning and technical aspects, and program evolution with provider experience.

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Establishing and Sustaining a New Hepatic Arterial Infusion Program: Early Program and Patient Selection Considerations

  • 章节

  • 发表日期：

    2025年

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  • Lauren M. Janczewski,
  • Kristoffer Lassen,
  • Ryan P. Merkow

摘要

Although hepatic artery infusion (HAI) chemotherapy has been an available modality to treat disseminated liver malignancies for several decades, there has been growing interest in HAI chemotherapy over the past several years (Ko and Karanicolas, Curr Oncol 21(1):e116–e121, 2014).While HAI was historically limited to a small number of highly specialized centers, new HAI programs have been gradually opening as more institutions gain interest in offering HAI as a potential treatment option for this complex subset of patients (Creasy et al., Ann Surg Oncol 27(13):5086–5095, 2020; Walker et al., J Surg Oncol 126(3):513–522, 2022; Muaddi et al., J Surg Oncol 123(1):252–260, 2021).The HAI Consortium Research Network (HCRN) was established in 2020, serving as a collaborative to facilitate research and collect data to analyze the safety, feasibility, and efficacy of HAI programs. While many new HAI programs that were developed over the last 20 years were found to be unsustainable and subsequently dissolved (Cavnar et al., HPB (Oxford) 24:S100, 2022), the HCRN currently has nearly 80 participating hospitals from around the world and new programs have more recently exhibited greater success. The most important phase impacting the success of a new HAI program is during its initial establishment and early experience. In this chapter, we discuss considerations prior to establishing a program, considerations for building a successful program, early patient selection, surgical planning and technical aspects, and program evolution with provider experience.