Hankui Hu1, Bin Huang1, Jichun Zhao1, Wentao Wang2, Qiang Guo1, Yukui Ma1. 1. Department of Vascular Surgery, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China. 2. Department of Liver Surgery, Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China.
Abstract
BACKGROUND: Alveolar echinococcosis (AE) is characterized by a slow-growing infiltrative neoplasm that is often unresectable by traditional methods because of strong adhesions and invasion to adjacent structures. We present our experience with liver autotransplantation and retrohepatic inferior vena cava (RHIVC) reconstruction using autogenous veins in patients with this end-stage parasitic disease. METHODS: Twelve patients with hepatic AE and extensive RHIVC, hepatic vein, and/or hilar invasion underwent ex vivo liver resection and RHIVC reconstruction using autogenous veins followed by autotransplantation in the West China Hospital of Sichuan University from 2013 to 2016. RESULTS: The mean weight of the harvested liver graft was 537 g (range: 390-900 g), the mean anhepatic time was 216 min (range, 120-310 min), and the mean operation time was 13.6 h (range, 10.5-19.5 h). The main postoperative complication was bile leakage. The mean postoperative hospital stay was 16.4 d (range, 10.0-37.0 d), and the median follow-up time was 15.5 mo (range, 1.0-32.0 mo). All patients were alive at the latest follow-up. The vascular patency rate was 100%, and no residual disease, recurrence, or metastasis was detected. CONCLUSIONS: To our knowledge, liver autotransplantation and RHIVC reconstruction using autogenous veins are rarely performed for patients with end-stage hepatic AE. This technique requires no organ donor, allogeneic, or artificial vessel implantation, postoperative immunosuppressive therapy, or long-term postoperative anticoagulant treatment. These benefits may make the treatment of select end-stage hepatic AE patients more affordable and effective.
BACKGROUND:Alveolar echinococcosis (AE) is characterized by a slow-growing infiltrative neoplasm that is often unresectable by traditional methods because of strong adhesions and invasion to adjacent structures. We present our experience with liver autotransplantation and retrohepatic inferior vena cava (RHIVC) reconstruction using autogenous veins in patients with this end-stage parasitic disease. METHODS: Twelve patients with hepatic AE and extensive RHIVC, hepatic vein, and/or hilar invasion underwent ex vivo liver resection and RHIVC reconstruction using autogenous veins followed by autotransplantation in the West China Hospital of Sichuan University from 2013 to 2016. RESULTS: The mean weight of the harvested liver graft was 537 g (range: 390-900 g), the mean anhepatic time was 216 min (range, 120-310 min), and the mean operation time was 13.6 h (range, 10.5-19.5 h). The main postoperative complication was bile leakage. The mean postoperative hospital stay was 16.4 d (range, 10.0-37.0 d), and the median follow-up time was 15.5 mo (range, 1.0-32.0 mo). All patients were alive at the latest follow-up. The vascular patency rate was 100%, and no residual disease, recurrence, or metastasis was detected. CONCLUSIONS: To our knowledge, liver autotransplantation and RHIVC reconstruction using autogenous veins are rarely performed for patients with end-stage hepatic AE. This technique requires no organ donor, allogeneic, or artificial vessel implantation, postoperative immunosuppressive therapy, or long-term postoperative anticoagulant treatment. These benefits may make the treatment of select end-stage hepatic AE patients more affordable and effective.
Authors: Lei Du; Ling-Qiang Zhang; Li-Zhao Hou; Li Ren; Hai-Jiu Wang; Xin-Jian Guo; Haining Fan Journal: Medicine (Baltimore) Date: 2017-09 Impact factor: 1.889
Authors: Yu Zhang; Eric C H Lai; Chong Yang; Hongji Yang; Jun Liu; Guo Zhou; Di Xian; Shaoping Deng; Wan Yee Lau Journal: Int J Surg Case Rep Date: 2020-03-28