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논문 기본 정보

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학술저널
저자정보
Yoon Young-In (Division of Hepatobiliary Surgery and Liver Transplantation Department of Surgery Asan Medical Cent) Hwang Shin (Division of Hepatobiliary Surgery and Liver Transplantation Department of Surgery Asan Medical Cent) Moon Deok-Bog (Division of Hepatobiliary Surgery and Liver Transplantation Department of Surgery Asan Medical Cent) Jung Dong-Hwan (Division of Hepatobiliary Surgery and Liver Transplantation Department of Surgery Asan Medical Cent) Lee Sung-Gyu (Division of Hepatobiliary Surgery and Liver Transplantation Department of Surgery Asan Medical Cent)
저널정보
대한이식학회 Clinical Transplantation and Research Korean Journal of Transplantation Vol.35 No.2
발행연도
2021.1
수록면
130 - 136 (7page)

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We present a case of recipient hepatectomy under total hepatic vascular exclusion (THVE) and venovenous bypass for living donor liver transplantation (LDLT) in a patient with multiple hepatocellular carcinomas (HCCs) closely located to the retrohepatic inferior vena cava (IVC). A 19-year-old male patient diagnosed with multiple HCCs underwent left lateral sectionectomy 14 months before and received four sessions of transarterial chemoembolization due to post-hepatectomy tumor recurrence. These pretransplant sequences implicated high risk of posttransplant HCC recurrence. However, LDLT was performed with expectation of prolonged survival. During recipient operation, the portal vein was transected and active venovenous bypass was performed. Supra- and infra-hepatic portions of the retrohepatic IVC were then clamped. Under THVE and portal vein bypass, recipient hepatectomy was meticulously performed. A modified right liver graft recovered from his brother was implanted according to standard procedures of LDLT. The patient recovered uneventfully from LDLT operation. However, multiple pulmonary metastasis occurred. The patient has been doing well for 12 months after LDLT, with administration of chemotherapeutic agents. Although early pulmonary metastasis occurred in this patient, we suggest that recipient hepatectomy under THVE and venovenous bypass can be a feasible technical option to cope with risk of iatrogenic tumor cell spread during LDLT operation.
#Hepatectomy #Tumor recurrence #Tumor cell spread #Inferior vena cava #Pulmonary metastasis

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참고문헌 (15)

참고문헌 신청
Mangus RS / 2008 / Use of the piggyback hepatectomy technique in liver transplant recipients with hepatocellular carcinoma / Transplantation 85:1496~1499 google schola Moon DB / 2013 / No-touch en bloc right lobe living-donor liver transplantation with inferior vena cava replacement for hepatocellular carcinoma close to retrohepatic inferior vena cava : case report / Transplant Proc 45:3135~3139 google schola Matsuda H / 2010 / Aggressive combined resection of hepatic inferior vena cava, with replacement by a ringed expanded polytetrafluoroethylene graft, in living-donor liver transplantation for hepatocellular carcinoma beyond the Milan criteria / J Hepatobiliary Pancreat Sci 17:719~724 google schola Smyrniotis VE / 2002 / Total versus selective hepatic vascular exclusion in major liver resections / Am J Surg 183:173~178 google schola Azoulay D / 2015 / Complex liver resection using standard total vascular exclusion, venovenous bypass, and in situ hypothermic portal perfusion: an audit of 77consecutive cases / Ann Surg 262:93~104 google schola

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