title: Good outcome following liver transplantation using pericardial-peritoneum window for hepato-atrial anastomosis to overcome advanced hepatic alveolar echinococcosis and secondary Budd-Chiari Syndrome - a case report.
abstract: BACKGROUND
  This report presents a case of a 57- year old female with advanced Hepatic Alveolar Echinococcosis causing a secondary Budd-Chiari Syndrome due to infiltration of the suprahepatic inferior vena cava treated successfully by liver transplantation.
  
  
  METHODS
  A temporary veno-venous bypass was introduced, but a typical end to end cavo-caval anastomosis wasn't possible in this case. In order to access a disease free part of the inferior vena cava, an oval window of the diaphragm was excised, providing communication between the peritoneum and pericardium. A vascular clamp was placed onto the right atrium which allowed for an atrial-caval anastomosis. The remainder of hepatectomy was performed in a conventional manner. In the post-operative period and during the 18 month follow-up there were no complications. The patient remains in good general condition with optimal graft function.
  
  
  CONCLUSIONS
  A hepato-atrial anastomosis with a pericardial-peritoneum window during liver transplantation is feasible and extends the curability potential for patients with advanced Hepatic Alveolar Echinococcosis considered for liver transplantation.
authors.affiliation: Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Poland. Banacha Street 1a, 02-097, Warsaw, Poland. konradkobryn@gmail.com.
authors.forename: Konrad
authors.initials: K
authors.lastname: Kobryń
authors.affiliation: Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Poland. Banacha Street 1a, 02-097, Warsaw, Poland.
authors.forename: Rafał
authors.initials: R
authors.lastname: Paluszkiewicz
authors.affiliation: Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Poland. Banacha Street 1a, 02-097, Warsaw, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Dudek
authors.affiliation: Department of Hepatology and Internal Diseases, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Urszula
authors.initials: U
authors.lastname: Ołdakowska-Jedynak
authors.affiliation: Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Poland. Banacha Street 1a, 02-097, Warsaw, Poland.
authors.forename: Michał
authors.initials: M
authors.lastname: Korba
authors.affiliation: Department of Hepatology and Internal Diseases, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Joanna
authors.initials: J
authors.lastname: Raszeja-Wyszomirska
authors.affiliation: Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Poland. Banacha Street 1a, 02-097, Warsaw, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Remiszewski
authors.affiliation: Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Poland. Banacha Street 1a, 02-097, Warsaw, Poland.
authors.forename: Michał
authors.initials: M
authors.lastname: Grąt
authors.affiliation: Department of Hepatology and Internal Diseases, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Milkiewicz
authors.affiliation: Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Poland. Banacha Street 1a, 02-097, Warsaw, Poland.
authors.forename: Waldemar
authors.initials: W
authors.lastname: Patkowski
authors.affiliation: Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Poland. Banacha Street 1a, 02-097, Warsaw, Poland.
authors.forename: Marek
authors.initials: M
authors.lastname: Krawczyk
mesh_terms: D006502:Budd-Chiari Syndrome / Q000209:etiology*; D004444:Echinococcosis, Hepatic / Q000150:complications / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D016031:Liver Transplantation; D008875:Middle Aged; D010496:Pericardium; D010537:Peritoneum; D014682:Vena Cava, Inferior
keywords: Atrium–IVC anastomosis; Budd-Chiari Syndrome; Case report; Hepatic alveolar Echinococcosis; Liver transplantation; Pericardial-peritoneum window