Is Combined Partial Hepatectomy With Segmental Resection of Inferior Vena Cava Justified for Malignancy?

Sarmiento, Juan M.

doi:10.1001/archsurg.138.6.624

Cited by 67 publications

(53 citation statements)

References 15 publications

(25 reference statements)

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“…Generally, long-term results regarding graft patency and graft-related complications are acceptable. Although there is a lack of long-term results for graft patency, several case reports have shown good patency during 1-to 11-year follow-up, 3,6,7,9,11 and one of the largest case series 2 shows favorable results of late prosthetic caval graft patency (> 90%) at a median follow-up of 3 years with long-term anticoagulation therapy. In the case of an anastomotic stenosis, this can be safely managed with radiologic intervention.…”

Section: Discussionmentioning

confidence: 99%

Living-Donor Liver Transplant With an Interposition Graft of the Inferior Vena Cava for Hepatocellular Carcinoma: Beyond the Milan Criteria and Within the UCSF Criteria

Ahn

Kang²,

Kim³

et al. 2013

Exp Clin Transplant

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Living-donor liver transplant for a big hepatocellular carcinoma located in the caudate lobe is challenging owing to dissemination of cancer cells during recipient hepatectomy. We report a case of living-donor liver transplant using the right side of the liver of a living donor combined with inferior vena cava interposition graft after en bloc resection of the liver and retrohepatic inferior vena cava for hepatocellular carcinoma in the caudate lobe. A 50-year-old man with chronic hepatitis B cirrhosis developed hepatocellular carcinoma in the caudate lobe and segment 5. The diameters of the masses were 4.5 cm and 2.5 cm. His model for end-stage liver disease score was 17, and he had a moderate amount of ascites. For the recipient hepatectomy, en bloc resection of the entire liver, including retrohepatic inferior vena cava and reconstruction of inferior vena cava with Dacron graft, were performed. We then performed a transplant of the right lobe taken from the living donor. This technique can be a new alternative curative treatment option for hepatocellular carcinoma located on the hepatocaval confluence or close to the inferior vena cava. We should evaluate the long-term safety for cancer recurrence and infection of an artificial vascular graft in the milieu of immunosuppression after liver transplant.

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Section: Discussionmentioning

confidence: 99%

Living-Donor Liver Transplant With an Interposition Graft of the Inferior Vena Cava for Hepatocellular Carcinoma: Beyond the Milan Criteria and Within the UCSF Criteria

Ahn

Kang²,

Kim³

et al. 2013

Exp Clin Transplant

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“…In the case of secondary liver cancer involving the IVC, long-term survival can be expected only in cases in whom the tumor can be totally resected [1, 4, 5]. However, the surgical techniques are complicated, and it is difficult to safely conduct surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Using this method, systemic and liver circulation can be preserved during total clamping of the IVC. Although the liver may tolerate warm ischemia for 60 min [12], the high mortality rate [3,4,5, 13] in hemihepatectomy with IVC reconstruction proved that liver ischemia should be avoided as much as possible during the operation. Our method is one strategy to ensure stable circulation and minimal liver damage during IVC reconstruction.…”

Section: Discussionmentioning

confidence: 99%

“…Combined resection of liver and inferior vena cava (IVC) has been shown to provide long-term survival and is the only possibility to obtain a cure, when the IVC is involved in metastatic liver cancer [1,2,3,4,5]. Even though innovative surgical techniques have been described in recent decades [6,7,8], the relatively high mortality rate is an obstacle to the operation.…”

Section: Introductionmentioning

confidence: 99%

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In situ Graft-Trimming Method Using Polyester Vascular Prosthesis for Inferior Vena Cava Reconstruction after Hepatectomy

Mizuguchi

Kimura²,

Morishita³

et al. 2006

Dig Surg

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Hepatectomy for secondary liver cancer that has invaded the inferior vena cava (IVC) can be the only way to achieve long-term survival. We describe a method for hepatectomy combined with partial IVC resection without venous bypass circulation and an in situ graft-trimming method to avoid graft size mismatch after reconstruction. We carried out left hepatectomy extended to segment 1 with partial IVC resection first. During resection and reconstruction of the IVC, it was clamped below the right hepatic vein and above the inferior right hepatic vein to maintain systemic circulation. The graft was trimmed in situ, after a half running suture of the graft was finished to ensure the correct size. Preservation of both inferior right hepatic vein and right hepatic vein helps to maintain systemic circulation during reconstruction of the IVC. The in situ graft-trimming method is an easy and safe method to ensure the correct graft size after IVC reconstruction.

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“…[1][2][3][4] Reports of living-donor liver transplant (LDLT) with total hepatectomy, including the retrohepatic vena cava and reconstruction of the IVC, have also been published. [5][6][7][8][9][10][11][12] For patients with hepatocellular carcinoma (HCC) combined with cirrhosis, a liver transplant remains the best option for long-term survival.…”

Section: Introductionmentioning

confidence: 99%

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Eldeen

Abdulfatah²,

Bröering³

2018

Exp Clin Transplant

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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.

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Is Combined Partial Hepatectomy With Segmental Resection of Inferior Vena Cava Justified for Malignancy?

Abstract: Hypothesis: En bloc partial hepatectomy with inferior vena cava (IVC) resection may be the only curative strategy for patients with hepatic malignancies involving the IVC.

Cited by 67 publications

References 15 publications

Living-Donor Liver Transplant With an Interposition Graft of the Inferior Vena Cava for Hepatocellular Carcinoma: Beyond the Milan Criteria and Within the UCSF Criteria

Living-Donor Liver Transplant With an Interposition Graft of the Inferior Vena Cava for Hepatocellular Carcinoma: Beyond the Milan Criteria and Within the UCSF Criteria

In situ Graft-Trimming Method Using Polyester Vascular Prosthesis for Inferior Vena Cava Reconstruction after Hepatectomy

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