title: Liver resection in transplanted patients: a single-center Western experience.
abstract: BACKGROUND
  Liver resection (LR) in liver transplant (OLT) recipients, an extremely rare situation, who performed on 8 recipients.
  
  
  METHODS
  This retrospective analysis of prospectively collected data concerned 8 (0.66%) 1198 LR cases among OLT performed from 1997 to 2011. We analyzed demographic data, surgical indications, and postoperative courses.
  
  
  RESULTS
  The indications were resectable recurrent hepatocellular carcinomas (HCC, n = 3), persistent fistula from a posterior sectorial duct (n = 1), recurrent cholangitis due to anastomotic stricture on the posterior sectorial duct (n = l), hydatid cyst (n = l), left arterial hepatic thrombosis with secondary ischemic cholangitis (n = 1), and a large symptomatic biliary cyst (n = 1). The mean interval time to liver resection was 23.7 months (range, 5-47). LR included right hepatectomy (n = 1), right posterior hepatectomy (n = 1), left lobectomy (n = 4), pericystectomy (n = 1), or biliary fenestration (n = 1). Which there was no postoperative mortality, the global morbidity rate was 62% (5/8). The mean follow-up after LR was 92 months (range, 11-156). No patients required retransplantation. None of the 3 patients who underwent LR for HCC showed a recurrence.
  
  
  CONCLUSIONS
  LR in OLT recipients is safe, but associated with a high morbidity rate. This procedure can avoid retransplantation in highly selected patients, presenting a possible option particularly for transplanted patients with a resectable, recurrent HCC.
authors.affiliation: Department of Hepatopancreatobiliary and Liver Transplantation, Beaujon University-Hospital, APHP, Paris Diderot University (Paris 7), France. Electronic address: dsommacale@chu-reims.fr.
authors.forename: D
authors.initials: D
authors.lastname: Sommacale
authors.forename: F
authors.initials: F
authors.lastname: Dondero
authors.forename: A
authors.initials: A
authors.lastname: Sauvanet
authors.forename: C
authors.initials: C
authors.lastname: Francoz
authors.forename: F
authors.initials: F
authors.lastname: Durand
authors.forename: O
authors.initials: O
authors.lastname: Farges
authors.forename: R
authors.initials: R
authors.lastname: Kianmanesh
authors.forename: J
authors.initials: J
authors.lastname: Belghiti
mesh_terms: D006801:Humans; D008107:Liver Diseases / Q000601:surgery; D016031:Liver Transplantation; D012189:Retrospective Studies