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A novel remnant liver-first strategy for liver autotransplantation in patients with end-stage hepatic alveolar echinococcosis: a retrospective case series
BACKGROUND: Ex vivo liver resection combined with autotransplantation is an effective therapeutic strategy for unresectable end-stage hepatic alveolar echinococcosis (HAE). However, ex vivo liver resection combined with autotransplantation is a technically demanding and time-consuming procedure asso...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10651293/ https://www.ncbi.nlm.nih.gov/pubmed/37994730 http://dx.doi.org/10.1097/JS9.0000000000000604 |
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author | Lv, Tao Xu, Gang Xu, Xi Wu, Gang Wan, Chen-Fei Song, Jiu-Lin Yang, Jian Zhou, Yong-Jie Luo, Kui Wu, Hong Ye, Cheng-Jie Yan, Lv-Nan Lau, Wan-Yee Yang, Jia-Yin |
author_facet | Lv, Tao Xu, Gang Xu, Xi Wu, Gang Wan, Chen-Fei Song, Jiu-Lin Yang, Jian Zhou, Yong-Jie Luo, Kui Wu, Hong Ye, Cheng-Jie Yan, Lv-Nan Lau, Wan-Yee Yang, Jia-Yin |
author_sort | Lv, Tao |
collection | PubMed |
description | BACKGROUND: Ex vivo liver resection combined with autotransplantation is an effective therapeutic strategy for unresectable end-stage hepatic alveolar echinococcosis (HAE). However, ex vivo liver resection combined with autotransplantation is a technically demanding and time-consuming procedure associated with significant morbidity and mortality. The authors aimed to present our novel remnant liver-first strategy of in vivo liver resection combined with autotransplantation (IRAT) technique for treating patients with end-stage HAE. METHODS: This retrospective study included patients who underwent IRAT between January 2014 and December 2020 at two institutions. Patients with end-stage HAE were carefully assessed for IRAT by a multidisciplinary team. The safety, feasibility, and outcomes of this novel technique were analyzed. RESULTS: IRAT was successfully performed in six patients, with no perioperative deaths. The median operative time was 537.5 min (range, 501.3–580.0), the median anhepatic time was 59.0 min (range, 54.0–65.5), and the median cold ischemia time was 165.0 min (range, 153.8–201.5). The median intraoperative blood loss was 700.0 ml (range, 475.0–950.0). In-hospital complications occurred in two patients. No Clavien–Dindo grade III or higher complications were observed. At a median follow-up of 18.6 months (range, 15.4–76.0) , all patients were alive. No recurrence of HAE was observed. CONCLUSION: The remnant liver-first strategy of IRAT is feasible and safe for selected patients with end-stage HAE. The widespread adoption of this novel technique requires further studies to standardize the operative procedure and identify patients who are most likely to benefit from it. |
format | Online Article Text |
id | pubmed-10651293 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-106512932023-11-15 A novel remnant liver-first strategy for liver autotransplantation in patients with end-stage hepatic alveolar echinococcosis: a retrospective case series Lv, Tao Xu, Gang Xu, Xi Wu, Gang Wan, Chen-Fei Song, Jiu-Lin Yang, Jian Zhou, Yong-Jie Luo, Kui Wu, Hong Ye, Cheng-Jie Yan, Lv-Nan Lau, Wan-Yee Yang, Jia-Yin Int J Surg Original Research BACKGROUND: Ex vivo liver resection combined with autotransplantation is an effective therapeutic strategy for unresectable end-stage hepatic alveolar echinococcosis (HAE). However, ex vivo liver resection combined with autotransplantation is a technically demanding and time-consuming procedure associated with significant morbidity and mortality. The authors aimed to present our novel remnant liver-first strategy of in vivo liver resection combined with autotransplantation (IRAT) technique for treating patients with end-stage HAE. METHODS: This retrospective study included patients who underwent IRAT between January 2014 and December 2020 at two institutions. Patients with end-stage HAE were carefully assessed for IRAT by a multidisciplinary team. The safety, feasibility, and outcomes of this novel technique were analyzed. RESULTS: IRAT was successfully performed in six patients, with no perioperative deaths. The median operative time was 537.5 min (range, 501.3–580.0), the median anhepatic time was 59.0 min (range, 54.0–65.5), and the median cold ischemia time was 165.0 min (range, 153.8–201.5). The median intraoperative blood loss was 700.0 ml (range, 475.0–950.0). In-hospital complications occurred in two patients. No Clavien–Dindo grade III or higher complications were observed. At a median follow-up of 18.6 months (range, 15.4–76.0) , all patients were alive. No recurrence of HAE was observed. CONCLUSION: The remnant liver-first strategy of IRAT is feasible and safe for selected patients with end-stage HAE. The widespread adoption of this novel technique requires further studies to standardize the operative procedure and identify patients who are most likely to benefit from it. Lippincott Williams & Wilkins 2023-09-02 /pmc/articles/PMC10651293/ /pubmed/37994730 http://dx.doi.org/10.1097/JS9.0000000000000604 Text en Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (https://creativecommons.org/licenses/by/4.0/) (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) |
spellingShingle | Original Research Lv, Tao Xu, Gang Xu, Xi Wu, Gang Wan, Chen-Fei Song, Jiu-Lin Yang, Jian Zhou, Yong-Jie Luo, Kui Wu, Hong Ye, Cheng-Jie Yan, Lv-Nan Lau, Wan-Yee Yang, Jia-Yin A novel remnant liver-first strategy for liver autotransplantation in patients with end-stage hepatic alveolar echinococcosis: a retrospective case series |
title | A novel remnant liver-first strategy for liver autotransplantation in patients with end-stage hepatic alveolar echinococcosis: a retrospective case series |
title_full | A novel remnant liver-first strategy for liver autotransplantation in patients with end-stage hepatic alveolar echinococcosis: a retrospective case series |
title_fullStr | A novel remnant liver-first strategy for liver autotransplantation in patients with end-stage hepatic alveolar echinococcosis: a retrospective case series |
title_full_unstemmed | A novel remnant liver-first strategy for liver autotransplantation in patients with end-stage hepatic alveolar echinococcosis: a retrospective case series |
title_short | A novel remnant liver-first strategy for liver autotransplantation in patients with end-stage hepatic alveolar echinococcosis: a retrospective case series |
title_sort | novel remnant liver-first strategy for liver autotransplantation in patients with end-stage hepatic alveolar echinococcosis: a retrospective case series |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10651293/ https://www.ncbi.nlm.nih.gov/pubmed/37994730 http://dx.doi.org/10.1097/JS9.0000000000000604 |
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