Inferior Vena Cava Replacement in Living-Donor Liver Transplant for Hepatocellular Carcinoma: First Case Report in Saudi Arabia.
Living-donor liver transplant for hepatocellular carcinoma located on hepatocaval confluence or in contact with the inferior vena cava is technically challenging, and candidates for this kind of procedure should be carefully selected. It is difficult to rule out major vascular invasion except after hepatectomy and histologic examination; in addition, the possible dissemination of cancer cells during recipient hepatectomy is a considerable risk. Herein, we report the first case in Saudi Arabia of right lobe living-donor liver transplant combined with inferior vena cava reconstruction using cryopreserved iliac vein graft after en bloc resection of the liver with part of the diaphragm, anterior wall of retrohepatic inferior vena cava, and a 5-cm hepatocellular carcinoma in segment 7. Our patient achieved so far 3-year disease-free survival. Tumor recurrence and risk of thrombosis related to inferior vena cava reconstruction are the main concerns; therefore, long-term follow-up of those patients is mandatory.
From the Departments of Liver and Small Bowel Transplantation and Hepatobiliary and Pancreatic Surgery, King Faisal Specialist Hospital and Research Hospital, Riyadh, Saudi Arabia.
Firas
F
Zahr Eldeen
Mohammed Rabie
MR
Abdulfatah
Dieter
D
Broering
D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D000072226:Computed Tomography Angiography; D005260:Female; D006801:Humans; D007084:Iliac Vein / Q000637:transplantation*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010690:Phlebography / Q000379:methods; D012529:Saudi Arabia; D016896:Treatment Outcome; D058017:Vascular Grafting / Q000379:methods*; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*