Liver transplantation for patients with hepatic alveolar echinococcosis in late stage.
BACKGROUND
Failed surgical treatment and multiple operations often lead to liver failure and make it difficult to be treated by traditional methods. Liver transplantation may be the ideal and the last choice. In this study we tried to explore the indication of liver transplantation for hepatic alveolar echinococcosis (HAE) and the improvement of intraoperative treatment.


METHODS
Five patients who had received liver transplantation of hepatic alveolar echinococcosis in our hospital from 1999 through 2003 were analyzed retrospectively.


RESULTS
All the patients (3 were male and 2 female) were in late stage of hepatic alveolar echinococcosis. During orthotopic liver transplantation(OLT), 4 patients underwent veno-venous bypass, 3 were subjected to veno-venous bypass prior to the mobilization of the liver, and 2 received placement of T tube in the bile duct. In all the patients treated successfully by OLT, 4 recovered, and 1 died of severe infection and acute rejection after operation. T tube fell off in one patient. Postoperatively, pathological diagnosis verified hepatic alveolar echinococcosis. Four patients were followed up to the present, showing a good life quality and work capacity.


CONCLUSIONS
Hepatic alveolar echinococcosis in late stage can be considered as one of the indications of liver transplantation. Technique of veno-venous bypass prior to the mobilization of the liver could decrease operative time and bleeding. Early diagnosis and treatment of the disease ensures a better prognosis.
Pan
Guang-Dong
GD
Center of Liver Transplantation, West China Hospital, Sichuan University, Chengdu 610041,China. pgdhx@126.com
Yan
Lu-Nan
LN
Li
Bo
B
Lu
Shi-Chun
SC
Zeng
Yong
Y
Wen
Tian-Fu
TF
Zhao
Ji-Chun
JC
Cheng
Nan-Sheng
NS
Ma
Yu-Kui
YK
Wang
Wen-Tao
WT
Yang
Jia-Yin
JY
Li
Zhi-Hui
ZH
D000293:Adolescent; D000328:Adult; D004444:Echinococcosis, Hepatic / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D016031:Liver Transplantation / Q000379:methods / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012189:Retrospective Studies; D016896:Treatment Outcome