Alfred Königsrainer1, Silke Templin1, Ivan Capobianco1, Ingmar Königsrainer1, Michael Bitzer2, Lars Zender3, Bence Sipos4, Lothar Kanz5, Silvia Wagner1, Silvio Nadalin1. 1. Department of General, Visceral and Transplant Surgery, University Hospital Tübingen, Tübingen, Germany. 2. Department of Internal Medicine I, University Hospital Tübingen, Tübingen, Germany. 3. Department of Internal Medicine VIII, University Hospital Tübingen, Tübingen, Germany. 4. Department of Pathology and Neuropathology, University Hospital Tübingen, University Hospital Tübingen, Tübingen, Germany. 5. Department of Oncology, Hematology, Immunology, Rheumatology and Pulmonology, University Hospital Tübingen, Tübingen, Germany.
Abstract
OBJECTIVE: to report the first case of resection and partial liver segment 2-3 transplantation with delayed total hepatectomy (RAPID) from living donor in a patient affected of irresectable colorectal liver metastases (i-CRLM) BACKGROUND: : A renaissance of liver transplantation (LT) for i-CRLM has been recently observed. The Norwegian SECA trial demonstrated a 5-year overall survival rate of approximately 60%, notwithstanding early tumor recurrence. The RAPID technique was recently introduced as alternative to whole deceased donor LT, but it is limited by poor availability of splittable organs and many organisational aspects. In this context left lateral living donor LT may be the ideal solution. METHODS: Report about the technique and results of living donor RAPID procedure. TECHNIQUE: A 49 years old woman affected with i-CRLM from adenocarcinoma of right colon, underwent a left hepatectomy with ligation of right portal vein maintaining the right hepatic artery patent. Subsequently, the left lateral lobe from her son was implanted as auxiliary partial orthotopic LT. Two weeks later completion of hepatectomy was performed. RESULTS: The donor postoperative course was uneventful. The recipient developed postoperatively a slight small for size syndrome which spontaneously resolved. No graft dysfunction and no rejection were observed. At POM 5 micrometastases occurred in bones and lungs, which were treated with radiotherapy and chemotherapy, respectively. Almost 2 years later the patient is alive, in good general condition, although slight progression of bone and lung metastases. CONCLUSIONS: LT poses a valid treatment option for i-CRLM. In times of organ paucity, "living donor-RAPID" procedure may represent a paradigm shift in the management of i-CRLM.
OBJECTIVE: to report the first case of resection and partial liver segment 2-3 transplantation with delayed total hepatectomy (RAPID) from living donor in a patient affected of irresectable colorectal liver metastases (i-CRLM) BACKGROUND: : A renaissance of liver transplantation (LT) for i-CRLM has been recently observed. The Norwegian SECA trial demonstrated a 5-year overall survival rate of approximately 60%, notwithstanding early tumor recurrence. The RAPID technique was recently introduced as alternative to whole deceased donor LT, but it is limited by poor availability of splittable organs and many organisational aspects. In this context left lateral living donor LT may be the ideal solution. METHODS: Report about the technique and results of living donor RAPID procedure. TECHNIQUE: A 49 years old woman affected with i-CRLM from adenocarcinoma of right colon, underwent a left hepatectomy with ligation of right portal vein maintaining the right hepatic artery patent. Subsequently, the left lateral lobe from her son was implanted as auxiliary partial orthotopic LT. Two weeks later completion of hepatectomy was performed. RESULTS: The donor postoperative course was uneventful. The recipient developed postoperatively a slight small for size syndrome which spontaneously resolved. No graft dysfunction and no rejection were observed. At POM 5 micrometastases occurred in bones and lungs, which were treated with radiotherapy and chemotherapy, respectively. Almost 2 years later the patient is alive, in good general condition, although slight progression of bone and lung metastases. CONCLUSIONS: LT poses a valid treatment option for i-CRLM. In times of organ paucity, "living donor-RAPID" procedure may represent a paradigm shift in the management of i-CRLM.
Authors: Eduardo de Souza M Fernandes; Pal-Dag Line; Felipe Pedreira de Mello; Ronaldo Oliveira Andrade; Camila Liberato Girão; Leandro Savattone Pimentel; Camilla César; Tarik Soares Suleiman; Fabio Luís Waechter; Antonio Talvane T Oliveira; Orlando Jorge M Torres Journal: Arq Bras Cir Dig Date: 2019-12-20
Authors: Cody M Lebeck Lee; Ioannis A Ziogas; Rajiv Agarwal; Sophoclis P Alexopoulos; Kristen K Ciombor; Lea K Matsuoka; Daniel B Brown; Cathy Eng Journal: Cancer Date: 2022-03-14 Impact factor: 6.921
Authors: Philip C Müller; Michael Linecker; Elvan O Kirimker; Christian E Oberkofler; Pierre-Alain Clavien; Deniz Balci; Henrik Petrowsky Journal: Langenbecks Arch Surg Date: 2021-03-19 Impact factor: 3.445