Liver Transplant for Posthepatectomy Liver Failure in Hepatoblastoma

Hirata, Yuta; Sanada, Yukihiro; Omameuda, Takahiko; Katano, Takumi; Miyahara, Go; Yamada, Naoya; Okada, Noriki; Onishi, Yuki; Sakuma, Yoshiki; Sata, Naohiro

doi:10.6002/ect.2019.0323

Cited by 4 publications

(5 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For this reason, there have been a few efforts to perform extended hepatectomy while preserving FLR. Moreover, the FLR threshold is not clearly defined in the pediatric population, and a threshold of 30% in adults with noncirrhotic liver disease is permitted ( 2 ).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Case report: Portal vein ligation: lessons from patients with PRETEXT III hepatoblastoma in restoring future liver remnant before major hepatectomy and literature review

Gang

Kwon

et al. 2023

Front. Surg.

View full text Add to dashboard Cite

BackgroundWe describe three cases involving three patients with PRETEXT III hepatoblastoma invading the hepatic hilum. After portal vein embolization, the patients underwent uncomplicated trisectionectomy.MethodsMedical records between March 2016 and March 2021 were reviewed, and three patients were selected. A literature review of techniques for increasing future liver remnant in children diagnosed with hepatoblastoma was also conducted.ResultsAll tumors involved the right lobe and hepatic hilum (PRETEXT III). After neoadjuvant chemotherapy, the tumor size decreased, but hilar involvement was unimproved. Right portal vein ligation (RPVL) was performed to increase the left lobe volume. Post-ligation, the remnant liver increased. Liver function was restored to normal levels within 5 days after the hepatectomy. All patients underwent two cycles of adjuvant chemotherapy without tumor recurrence.ConclusionsRPVL can be safely performed before extended hepatic resection in children with a giant hepatoblastoma invading the hepatic hilum. The tumor was completely resected by securing a sufficient margin and increasing the residual liver volume with portal vein embolization. The patients recovered and underwent adjuvant chemotherapy without the deterioration of liver function.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Hepatoblastomas (HBLs) account for 80% of pediatric primary liver tumors and occur in children before the age of 5 years ( 1 , 2 ). The basis of treatment is surgical resection, chemotherapy, and liver transplantation.…”

Section: Introductionmentioning

confidence: 99%

Case report: Portal vein ligation: lessons from patients with PRETEXT III hepatoblastoma in restoring future liver remnant before major hepatectomy and literature review

Gang

Kwon

et al. 2023

Front. Surg.

View full text Add to dashboard Cite

show abstract

“…There are very few studies that specifically reported or investigated PHLF in pediatric patients. Hirata et al reported on four patients that suffered from PHLF after trisectionectomy with consecutive necessity of liver transplantation ( 5 ). The authors defined PHLF as a peak of serum bilirubin >7.0 mg/dl at any postoperative day and did not differentiate between different grades of PHLF.…”

Section: Discussionmentioning

confidence: 99%

“…Posthepatectomy liver failure (PHLF) and small for size syndrome are well defined in the adult population, and have been shown to be a life-threatening complication ( 2 – 4 ). However, its role is less prominent in pediatric liver surgery, and definitions and prognostic values have not been validated in children ( 5 ). This has several reasons, some of which are evident, while others might not have been fully understood yet.…”

Section: Introductionmentioning

confidence: 99%

“…In the pediatric population, such definitions are lacking, and there is no consensus on a validated definition of post-resection liver insufficiency. While some authors applied methods from adult liver surgery ( 5 , 12 , 13 ), it is unknown whether these principles derived from research and experience in adult liver resection can be transferred to pediatric hepatobiliary surgery.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Evidence on Indications and Techniques to Increase the Future Liver Remnant in Children Undergoing Extended Hepatectomy: A Systematic Review and Meta-Analysis of Individual Patient Data

et al. 2022

View full text Add to dashboard Cite

BackgroundTechniques to increase the future liver remnant (FLR) have fundamentally changed the indications and criteria of resectability in adult liver surgery. In pediatric patients however, these procedures have rarely been applied and the potential benefit or harm as well as suited indications are unclear.MethodsA systematic literature search of MEDLINE, Web of Science, and CENTRAL was conducted. Based on a PRISMA-compliant, predefined methodology, all studies reporting pediatric patients (< 18y) undergoing liver resection with either associating liver partition and portal vein ligation for stages hepatectomy (ALPPS) or preoperative portal vein embolization or ligation (PVE/PVL) were included. Baseline data, periinterventional morbidity, increase of FLR and outcomes were analyzed.Results15 studies reporting on 21 pediatric patients with a mean age of 4 years and 7 months (range 1.8 months – 17 years) were included. 12 ALPPS procedures, 8 PVE and 1 PVL were performed. The applied criteria for performing ALPPS or PVE were heterogenous and thresholds for minimally acceptable FLR varied. Mean FLR [% of total liver volume] before the intervention was 23.6% (range 15.0 – 39.3%) in the ALPPS group and 31.4% (range 21.5 – 56.0%) in the PVE group. Mean increase of FLR before stage 2 resection was 69.4% (range 19.0 – 103.8%) for ALPPS and 62.8% (range 25.0 – 108.0%) after PVE. No postoperative death occurred, one early intrahepatic recurrence after an ALPPS procedure was reported. Overall postoperative morbidity was 23.8%.ConclusionValidated criteria for minimal FLR in pediatric liver resection are lacking and so are clear indications for ALPPS or PVE. In special cases, ALPPS and PVE can be valuable techniques to achieve complete resection of pediatric liver tumors. However, more data are needed, and future studies should focus on a definition and validation of posthepatectomy liver failure as well as the minimally needed FLR in pediatric patients undergoing extended hepatectomy.Systematic Review Registration[www.clinicaltrials.gov], identifier [PROSPERO 2021 CRD42021274848].

show abstract

Multiple drugs

2020

Reactions Weekly

View full text Add to dashboard Cite

Liver Transplant for Posthepatectomy Liver Failure in Hepatoblastoma

Cited by 4 publications

References 34 publications

Case report: Portal vein ligation: lessons from patients with PRETEXT III hepatoblastoma in restoring future liver remnant before major hepatectomy and literature review

Case report: Portal vein ligation: lessons from patients with PRETEXT III hepatoblastoma in restoring future liver remnant before major hepatectomy and literature review

Evidence on Indications and Techniques to Increase the Future Liver Remnant in Children Undergoing Extended Hepatectomy: A Systematic Review and Meta-Analysis of Individual Patient Data

Multiple drugs

Contact Info

Product

Resources

About