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R apid Procedure; Resection and partial liver transplantation with delayed total hepatectomy, evolved using combination of techniques from Auxiliary Partial Orthotopic Liver Transplantation (APOLT) and Associating Liver Partition and Portal vein ligation for Staged hepatectomy (ALPPS) Procedures in order to offer timely liver transplantation (LT) for the treatment of unresectable colorectal liver metastases, has shown promising results in selected patients. 1,2 Both Rapid and Apolt procedures were developed and mostly performed for the noncirrhotic settings. Here, we present the first case with high model for end stage liver disease (MELD) score, cirrhotic patient with portal vein thrombosis (PVT), showing that Rapid Procedure could be performed in complex clinical scenarios of Liver cirrhosis and PHT.

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Background Liver surgery and transplantation currently represent the only curative treatment options for primary and secondary hepatic malignancies. Despite the ability of the liver to regenerate after tissue loss, 25–30% future liver remnant is considered the minimum requirement to prevent serious risk for post-hepatectomy liver failure. Purpose The aim of this review is to depict the various interventions for liver parenchyma augmentation–assisting surgery enabling extended liver resections. The article summarizes one- and two-stage procedures with a focus on hypertrophy- and corresponding resection rates. Conclusions To induce liver parenchymal augmentation prior to hepatectomy, most techniques rely on portal vein occlusion, but more recently inclusion of parenchymal splitting, hepatic vein occlusion, and partial liver transplantation has extended the technical armamentarium. Safely accomplishing major and ultimately total hepatectomy by these techniques requires integration into a meaningful oncological concept. The advent of highly effective chemotherapeutic regimen in the neo-adjuvant, interstage, and adjuvant setting has underlined an aggressive surgical approach in the given setting to convert formerly “palliative” disease into a curative and sometimes in a “chronic” disease.

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