Ex Vivo Liver Resection and Autotransplantation for End-Stage Alveolar Echinococcosis: A Case Series
| Autor: | H. Gu, J.-M. Zhao, T. Li, Y.-R. Liang, Tuerhongjiang Tuxun, W.-D. Duan, Y.-B. He, J.-F. Huang, J.-H. Zhang, J.-H. Dong, Q.-W. Tai, Y.-M. Shao, X.-W. Ji, H. Wen |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty Echinococcosis Hepatic Adolescent medicine.medical_treatment Alveolar echinococcosis Vena Cava Inferior Hepatic Veins Transplantation Autologous Resection 03 medical and health sciences Young Adult 0302 clinical medicine Risk Factors medicine Immunology and Allergy Hepatectomy Humans Pharmacology (medical) Prospective Studies Stage (cooking) Grade IIIa Transplantation business.industry Graft Survival Postoperative complication Middle Aged Prognosis Autotransplantation Surgery Liver Transplantation 030220 oncology & carcinogenesis Operative time 030211 gastroenterology & hepatology Female business Ex vivo Follow-Up Studies |
| Zdroj: | American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons. 16(2) |
| ISSN: | 1600-6143 |
| Popis: | The role of autotransplantation in end-stage hepatic alveolar echinococcosis (AE) is unclear. We aimed to present our 15-case experience and propose selection criteria for autotransplantation. All patients were considered to have unresectable hepatic AE by conventional resection due to critical invasion to retrohepatic vena cava, hepatocaval region along with three hepatic veins, and the tertiary portal and arterial branches. All patients successfully underwent ex vivo extended right hepatectomy and autotransplantation without intraoperative mortality. The median autograft weight was 706 g (380-1000 g); operative time was 15.5 hours (11.5-20.5 hours); and anhepatic time was 283.8 minutes (180-435 min). Postoperative hospital stay was 32.3 days (12-60 days). Postoperative complication Clavien-Dindo grade IIIa or higher occurred in three patients including one death that occurred 12 days after the surgery due to acute liver failure. One patient was lost to follow-up after the sixth month. Thirteen patients were followed for a median of 21.6 months with no relapse. This is the largest reported series of patients with end-stage hepatic AE treated with liver autotransplantation. The technique requires neither organ donor nor postoperative immunosuppressant. The early postoperative mortality was low with acceptable morbidity. Preoperative precise assessment and strict patient selection are of utmost importance. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text