title: Living donor liver transplantation with replacement of vena cava for Echinococcus alveolaris: A case report.
abstract: BACKGROUND
  There is no medical treatment for alveolar echinococceal disease (AED) of liver till now. Curative surgical resection is optimal treatment but in most advanced cases curative resection can't be done. Liver transplantation is accepted treatment option for advanced AED. AED in some case invade surrounding tissue especially inferior vena cava (IVC). Advanced AED with invasion to IVC can be treated with deceased liver transplantation. Although living donor liver transplantation is very difficult to perform in patients with advanced AED with resected IVC, it come into consideration, since there is very few cadaveric liver.
  
  
  METHODS
  Here we present a case with advanced stage of AED of liver which cause portal hypertension and cholestasis. AED invaded surrounding tissue, right diaphragm, both lobes of liver and retrohepatic part of IVC. Invasion of IVC forced us to make resection of IVC and reconstruction with cryopreserved venous graft to reestablish blood flow. After that a living donor liver transplantation was done.
  
  
  CONCLUSIONS
  Curative surgery is the first-choice option in all operable patients with AED of liver. Advanced stage of AED like chronic jaundice, liver abscess, sepsis, repeated attacks of cholangitis, portal hypertension, and Budd-Chiari syndrome may be an indication for liver transplantation. In some advanced stage AED during transplantation replacement of retrohepatic part of IVC could be done with artificial vascular graft, cadaveric aortic and caval vein graft.
  
  
  CONCLUSIONS
  Although living donor liver transplantation with replacement of IVC is a very difficult operation, it should be considered in the management of advanced AED of liver with IVC invasion because of the rarity of deceased liver.
authors.affiliation: Inonu University, Liver Transplantation Institute, Malatya, Turkey; Azerbaijan Medical University, Baku, Azerbaijan.
authors.forename: Ruslan
authors.initials: R
authors.lastname: Mamedov
authors.affiliation: Inonu University, Liver Transplantation Institute, Malatya, Turkey; Central Customs Hospital, Baku, Azerbaijan.
authors.forename: Namig
authors.initials: N
authors.lastname: Novruzov
authors.affiliation: Inonu University, Liver Transplantation Institute, Malatya, Turkey.
authors.forename: Adil
authors.initials: A
authors.lastname: Baskiran
authors.affiliation: Department of General Surgery, Atatürk Research and Training Hospital, Ankara, Turkey; Inonu University, Liver Transplantation Institute, Malatya, Turkey. Electronic address: drfahriyetisir@hotmail.com.
authors.forename: Fahri
authors.initials: F
authors.lastname: Yetisir
authors.affiliation: Inonu University, Liver Transplantation Institute, Malatya, Turkey.
authors.forename: Bulent
authors.initials: B
authors.lastname: Unal
authors.affiliation: Inonu University, Liver Transplantation Institute, Malatya, Turkey.
authors.forename: Cemalettın
authors.initials: C
authors.lastname: Aydın
authors.affiliation: Azerbaijan Medical University, Baku, Azerbaijan.
authors.forename: Nuru
authors.initials: N
authors.lastname: Bayramov
authors.affiliation: Inonu University, Liver Transplantation Institute, Malatya, Turkey.
authors.forename: Cuneyt
authors.initials: C
authors.lastname: Kayaalp
authors.affiliation: Inonu University, Liver Transplantation Institute, Malatya, Turkey.
authors.forename: Sezai
authors.initials: S
authors.lastname: Yilmaz
keywords: Echinococcus alveolaris; Inferior vena cava; Living donor liver transplantation