title: Liver transplantation with an uncommon full right hemiliver graft after hydatid cysts resection: Case report and review of the literature.
abstract: Because of widespread organ shortage, the transplant community has been exploiting more and more so-called "extended criteria" donors. In this scenario, liver grafts harboring benign tumors or large cysts represent an infrequent but potentially valuable source of viable grafts. We depict a challenging case of liver transplantation performed using a graft harboring two large Echinococcus granulosus hydatid cysts in close proximity with the hilar plate and complicated by cystobiliary communication. Although liver transplantation using grafts with hydatid cyst has been rarely reported (three published cases), our case was peculiar as one of the cysts was located close to the hilum and was ruptured into the left hepatic duct. The graft was finally accepted taking into account the low risk profile of the recipient, the good quality and size of the remnant liver parenchyma, and only after complete resection of the cysts was achieved. Although the recipient had a complication due to biliary confluence necrosis, at 10-months follow-up he is in good health with normal hepatic function, and a graft that could have been otherwise discarded was successfully used. The decision process along with technical and management issues are discussed.
authors.affiliation: General Surgery 2U - Liver Transplantation Center, A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy.
authors.forename: Damiano
authors.initials: D
authors.lastname: Patrono
authors.affiliation: General Surgery 2U - Liver Transplantation Center, A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Tandoi
authors.affiliation: General Surgery 2U - Liver Transplantation Center, A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy.
authors.forename: Giorgia
authors.initials: G
authors.lastname: Rizza
authors.affiliation: General Surgery 2U - Liver Transplantation Center, A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy.
authors.forename: Giorgia
authors.initials: G
authors.lastname: Catalano
authors.affiliation: General Surgery 2U - Liver Transplantation Center, A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Mirabella
authors.affiliation: General Surgery 2U - Liver Transplantation Center, A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy.
authors.forename: Piero
authors.initials: P
authors.lastname: Celoria
authors.affiliation: Infectious Diseases, Department of Medical Sciences, University of Turin, Turin, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Corcione
authors.affiliation: Infectious Diseases, Department of Medical Sciences, University of Turin, Turin, Italy.
authors.forename: Francesco Giuseppe
authors.initials: FG
authors.lastname: De Rosa
authors.affiliation: General Surgery 2U - Liver Transplantation Center, A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Salizzoni
authors.affiliation: General Surgery 2U - Liver Transplantation Center, A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy.
authors.forename: Renato
authors.initials: R
authors.lastname: Romagnoli
mesh_terms: D064591:Allografts / Q000473:pathology; D000818:Animals; D001659:Biliary Tract / Q000000981:diagnostic imaging / Q000473:pathology*; D002758:Cholangiography; D046148:Donor Selection / Q000379:methods* / Q000592:standards; D004443:Echinococcosis / Q000469:parasitology / Q000601:surgery*; D004444:Echinococcosis, Hepatic / Q000469:parasitology / Q000601:surgery*; D048209:Echinococcus granulosus; D005260:Female; D006801:Humans; D008099:Liver / Q000469:parasitology / Q000601:surgery; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D020858:Tissue and Organ Harvesting / Q000379:methods* / Q000592:standards; D009927:Tissue and Organ Procurement / Q000592:standards
keywords: extended criteria grafts; hydatid cyst; liver hydatidosis; liver packing; liver transplantation; pericystectomy