Living Donor Liver Transplantation as a Backup Procedure: Treatment Strategy for Hepatocellular Adenomas Requiring Complex Resections.

Autor: Fonseca EA; Liver Transplant Unit, Hospital Sirio-Libanes, São Paulo, Brazil.; Liver Transplant Unit, A.C. Camargo Cancer Center, São Paulo, Brazil., Feier F; Liver Transplant Unit, Santa Casa de Porto Alegre, RS, Brazil., Vincenzi R; Liver Transplant Unit, Hospital Sirio-Libanes, São Paulo, Brazil.; Liver Transplant Unit, A.C. Camargo Cancer Center, São Paulo, Brazil., Candido HLL; Liver Transplant Unit, Hospital Sirio-Libanes, São Paulo, Brazil.; Liver Transplant Unit, A.C. Camargo Cancer Center, São Paulo, Brazil., Azambuja RL; Department of Radiology and Imaging, Hospital Sirio-Libanes, Brazil., Payao F; Department of Radiology and Imaging, Hospital Sirio-Libanes, Brazil., Benavides MR; Liver Transplant Unit, Hospital Sirio-Libanes, São Paulo, Brazil.; Liver Transplant Unit, A.C. Camargo Cancer Center, São Paulo, Brazil., Roda KMO; Liver Transplant Unit, Hospital Sirio-Libanes, São Paulo, Brazil.; Liver Transplant Unit, A.C. Camargo Cancer Center, São Paulo, Brazil., Leite KMR; Department of Pathology, Hospital Sirio-Libanes, Brazil., Ribeiro CMF; Department of Pathology, Hospital Sirio-Libanes, Brazil., Begnami MD; Department of Pathology, A.C. Camargo Cancer Center, Brazil., Zurstrassen CE; Vascular and Interventional Radiology Department, A.C. Camargo Cancer Center, Brazil., Carnevale FC; Vascular and Interventional Radiology Section, Hospital Sirio-Libanes, Brazil., Chapchap P; Liver Transplant Unit, Hospital Sirio-Libanes, São Paulo, Brazil., Seda-Neto J; Liver Transplant Unit, Hospital Sirio-Libanes, São Paulo, Brazil.; Liver Transplant Unit, A.C. Camargo Cancer Center, São Paulo, Brazil.
Jazyk: angličtina
Zdroj: Case reports in surgery [Case Rep Surg] 2022 Feb 17; Vol. 2022, pp. 1015061. Date of Electronic Publication: 2022 Feb 17 (Print Publication: 2022).
DOI: 10.1155/2022/1015061
Abstrakt: Methods: We present a series of three patients with large hepatocellular adenoma lesions showing a central location, for which the living donor liver transplantation strategy was used as a backup procedure.
Results: Hepatocellular adenoma was confirmed by biopsy in all patients. Surgical resection was indicated because of the patients' symptoms and lesion size and growth. All patients had a lesion that was central or in close contact with major vessels. The final decision to proceed with the resection was made intraoperatively. A live donor was prepared for all three patients. Two patients underwent portal vein embolization associated with extended hepatectomy, and a total hepatectomy plus liver transplantation with a living donor was performed in one patient. All patients had good postoperative outcomes.
Conclusions: In the treatment of hepatocellular adenomas for which complex resections are necessary and resectability can only be confirmed intraoperatively, surgical safety can be improved through the use of a living donor backup. Center expertise with living donor liver transplantation is paramount for the success of this approach.
Competing Interests: The authors have no conflicts of interest to declare.
(Copyright © 2022 Eduardo A. Fonseca et al.)
Databáze: MEDLINE
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