Ruslan Mamedov1, Namig Novruzov2, Adil Baskiran3, Fahri Yetisir4, Bulent Unal3, Cemalettın Aydın3, Nuru Bayramov5, Cuneyt Kayaalp3, Sezai Yilmaz3. 1. Inonu University, Liver Transplantation Institute, Malatya, Turkey; Azerbaijan Medical University, Baku, Azerbaijan. 2. Inonu University, Liver Transplantation Institute, Malatya, Turkey; Central Customs Hospital, Baku, Azerbaijan. 3. Inonu University, Liver Transplantation Institute, Malatya, Turkey. 4. Department of General Surgery, Atatürk Research and Training Hospital, Ankara, Turkey; Inonu University, Liver Transplantation Institute, Malatya, Turkey. Electronic address: drfahriyetisir@hotmail.com. 5. Azerbaijan Medical University, Baku, Azerbaijan.
Abstract
INTRODUCTION: There is no medical treatment for alveolar echinococceal disease (AED) of liver till now. Curative surgical resection is optimal treatment but in most advanced cases curative resection can't be done. Liver transplantation is accepted treatment option for advanced AED. AED in some case invade surrounding tissue especially inferior vena cava (IVC). Advanced AED with invasion to IVC can be treated with deceased liver transplantation. Although living donor liver transplantation is very difficult to perform in patients with advanced AED with resected IVC, it come into consideration, since there is very few cadaveric liver. PRESENTATION OF CASE: Here we present a case with advanced stage of AED of liver which cause portal hypertension and cholestasis. AED invaded surrounding tissue, right diaphragm, both lobes of liver and retrohepatic part of IVC. Invasion of IVC forced us to make resection of IVC and reconstruction with cryopreserved venous graft to reestablish blood flow. After that a living donor liver transplantation was done. DISCUSSION: Curative surgery is the first-choice option in all operable patients with AED of liver. Advanced stage of AED like chronic jaundice, liver abscess, sepsis, repeated attacks of cholangitis, portal hypertension, and Budd-Chiari syndrome may be an indication for liver transplantation. In some advanced stage AED during transplantation replacement of retrohepatic part of IVC could be done with artificial vascular graft, cadaveric aortic and caval vein graft. CONCLUSION: Although living donor liver transplantation with replacement of IVC is a very difficult operation, it should be considered in the management of advanced AED of liver with IVC invasion because of the rarity of deceased liver.
INTRODUCTION: There is no medical treatment for alveolar echinococceal disease (AED) of liver till now. Curative surgical resection is optimal treatment but in most advanced cases curative resection can't be done. Liver transplantation is accepted treatment option for advanced AED. AED in some case invade surrounding tissue especially inferior vena cava (IVC). Advanced AED with invasion to IVC can be treated with deceased liver transplantation. Although living donor liver transplantation is very difficult to perform in patients with advanced AED with resected IVC, it come into consideration, since there is very few cadaveric liver. PRESENTATION OF CASE: Here we present a case with advanced stage of AED of liver which cause portal hypertension and cholestasis. AED invaded surrounding tissue, right diaphragm, both lobes of liver and retrohepatic part of IVC. Invasion of IVC forced us to make resection of IVC and reconstruction with cryopreserved venous graft to reestablish blood flow. After that a living donor liver transplantation was done. DISCUSSION: Curative surgery is the first-choice option in all operable patients with AED of liver. Advanced stage of AED like chronic jaundice, liver abscess, sepsis, repeated attacks of cholangitis, portal hypertension, and Budd-Chiari syndrome may be an indication for liver transplantation. In some advanced stage AED during transplantation replacement of retrohepatic part of IVC could be done with artificial vascular graft, cadaveric aortic and caval vein graft. CONCLUSION: Although living donor liver transplantation with replacement of IVC is a very difficult operation, it should be considered in the management of advanced AED of liver with IVC invasion because of the rarity of deceased liver.
Authors: G Moray; R Shahbazov; S Sevmis; H Karakayali; A Torgay; G Arslan; N Savas; U Yilmaz; M Haberal Journal: Transplant Proc Date: 2009-09 Impact factor: 1.066
Authors: Esperance A K Schaefer; James Meixiong; Christina Mark; Amy Deik; Daniel L Motola; Dahlene Fusco; Andrew Yang; Cynthia Brisac; Shadi Salloum; Wenyu Lin; Clary B Clish; Lee F Peng; Raymond T Chung Journal: World J Gastroenterol Date: 2016-12-07 Impact factor: 5.742