title: Ex vivo liver resection followed by autotransplantation to a patient with advanced alveolar echinococcosis with a replacement of the retrohepatic inferior vena cava using autogenous vein grafting: a case report and literature review.
abstract: Alveolar echinococcosis (AE) of the liver is a rare disease. In advanced cases of this parasitic disease, the inferior vena cava (IVC) can be invaded; in these cases, the optimal treatment is liver transplantation and replacement of the IVC. Considering the donor shortage and the drawbacks of immunosuppressive therapy, ex vivo liver resection followed by autotransplantation may be the first choice for these patients. We report the first case of advanced AE successfully treated by an ex vivo liver resection, followed by autotransplantation with a replacement of the retrohepatic IVC using autogenous vein grafting. This graft included the following regions: the bilateral great saphenous vein, part of the retrohepatic inferior vena and the middle hepatic vein with no invasion, the inferior mesenteric vein, and part of the side wall of the infrahepatic vena cava. This patient had an uneventful postoperative recovery; currently, she has been enjoying a normal life and is 12 months postoperative with no immunosuppressive therapy or AE recurrence.In conclusion, ex vivo liver resection followed by autotransplantation with a replacement of the retrohepatic IVC using autogenous vein grafting might be a useful surgical practice for advanced AE.
authors.affiliation: From the Department of Liver Surgery (LJ, HO, WW); Vascular surgery (ZJ, HB, YD); ; Transplantation Center (YL), West China Hospital of Sichuan University, Chengdu, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Jianyong
authors.forename: Hao
authors.initials: H
authors.lastname: Jingcheng
authors.forename: Wang
authors.initials: W
authors.lastname: Wentao
authors.forename: Yan
authors.initials: Y
authors.lastname: Lunan
authors.forename: Zhao
authors.initials: Z
authors.lastname: Jichun
authors.forename: Huang
authors.initials: H
authors.lastname: Bing
authors.forename: Yuan
authors.initials: Y
authors.lastname: Ding
mesh_terms: D000328:Adult; D004443:Echinococcosis; D004444:Echinococcosis, Hepatic / Q000601:surgery*; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000379:methods*; D014182:Transplantation, Autologous; D014682:Vena Cava, Inferior / Q000601:surgery*