Living donor liver transplantation for giant hepatic hemangioma with Kasabach-Merritt syndrome with a posterior segment graft

Kumashiro, Yuji; Kasahara, Mureo; Nomoto, Kazuhiro; Kawai, Masao; Sasaki, Katsuya; Kiuchi, Tetsuya; Tanaka, Kōichi

doi:10.1053/jlts.2002.33689

Cited by 54 publications

(37 citation statements)

References 19 publications

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“…1 Most hepatic hemangiomas are relatively small and asymptomatic which do not need specific treatments. [2][3][4] However, treatment is required for patients with large hepatic hemangioma (≥5 cm in diameter), especially for those with obvious symptoms and signs and complications such as anemia, hemorrhage, jaundice, thrombocytopenia and hypofibrinogenemia, 5,6 as well as those with indefinite diagnoses 7,8 .…”

Section: Introductionmentioning

confidence: 99%

Efficacy, safety and feasibility of ultrasound‐guided percutaneous microwave ablation for large hepatic hemangioma

Tang

Wang

et al. 2015

J of Digest Diseases

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OBJECTIVE:To evaluate the efficacy, safety and feasibility of microwave ablation (MWA) for large (5-10 cm in diameter) hepatic hemangioma. METHODS:In all, 46 patients with 47 large hepatic hemangiomas were treated with ultrasound-guided percutaneous MWA. The effect of MWA for all patients was evaluated by enhanced magnetic resonance imaging or computed tomography within two months after ablation. RESULTS:A total of 27 male and 19 female patients were enrolled, with an average age of 46 ± 11 years. The average size of hemangiomas was 6.3 ± 1.4 cm (range 5.0-9.6 cm). The initial complete ablation rate was 91.5% (43/47) and the volume of ablated lesions was significantly reduced. The rate of complete necrosis was not associated with the tumor size or location (P = 0.899 and 0.758, respectively). The total complete ablation rate was 95.7% (45/47). Major complications included acute renal dysfunction, hyperbilirubinemia and pleural effusion. No procedure-related death occurred. The average hospitalization stay was 5.7 ± 2.5 days (range 3-17 days). During a follow-up period of 18.2 months (range 4-40 months), one patient developed local tumor progression at the radiofrequency ablation site. Three patients had new hemangiomas in other sites of the liver. At the end of the study all patients were alive and no severe complications occurred. CONCLUSION:Image-guided MWA is an effective and safe treatment for large hepatic hemangiomas, and can potentially be regarded as the first-line therapy.

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Section: Introductionmentioning

confidence: 99%

Efficacy, safety and feasibility of ultrasound‐guided percutaneous microwave ablation for large hepatic hemangioma

Tang

Wang

et al. 2015

J of Digest Diseases

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“…Symptomatic giant haemangiomas require some form of treatment as radiation, arterial embolization, surgical resection, or liver transplantation [10,11].…”

Section: Discussionmentioning

confidence: 99%

Surgical Treatment of Giant Cavernous Hepatic Haemangiomas

Salama¹,

Abdullah²,

Houseni³

2012

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Background: Haemangiomas are the most common benign liver tumors. Treatment is indicated for symptomatic tumors, rapid increase in size, rupture or doubt in diagnosis. Objective: Evaluation the efficacy of surgical treatment of giant cavernous hepatic haemangioma in tertiary hepatobiliary center. Patients and Methods: Retrospective study of 34 patients with giant hepatic haemangioma operated upon. The diagnosis was proved preoperatively in 27 patients and confirmed by histopathology postoperatively in all patients. The indication of surgery was abdominal pain with large sizes tumors, rapid growth, and spontaneous rupture with haemoperitoneum. Surgical treatment either liver resection or living liver transplantation. Results: 23 cases (67.6%) were females & 11 cases (32.4%) were males, median age 38.8 years. Haemangiomas located in right lobe in 19 patients (55.9%), left lobe in 12 patients (35.4%) in both lobe in 2 patients (5.8%), scattered all over both lobe in one patient (2.9%), solitary in 27 cases (79.4%) and multiple in 7 patients (20.6%). The diameter was 8 -27 cm, mean 18.6 cm in diameter. 33 patients had liver resection (29 elective resection and 4 emergent resection for rupture). One patient had haemangioma irresectable; the living liver transplant was performed. No mortality during 18 months follow up and complication occurred in 8 patients out of 34 patients. Conclusion: Hepatic resection is an effective treatment option for giant cavernous hepatic haemangioma, in selected patient living related liver transplantation may be the only therapeutic option.

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“…[1][2][3][4][5][6][7] The benefit of liver transplantation is its simple surgical concept, and the benefits of ECHR are that it is immunosuppression-free and that organ donors are unnecessary. [1][2][3][4][5][6] The patient was a 39-year-old female referred to our hospital for possible living donor liver transplantation for her huge and multiple unresectable hemangiomas of the liver.…”

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confidence: 99%

“…As is well known, the chance of receiving a liver graft from a deceased donor is almost zero in Japan. [7][8][9] The estimated autograft volume after ECHR was 590 g, representing a graft volume/standard liver volume ratio of 49.6% (Fig. 2).…”

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Extracorporeal hepatic resection for unresectable giant hepatic hemangiomas

et al. 2007

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In order to perform surgical treatment for tumors unresectable for anatomical reasons, there are two approaches: one is liver transplantation, and the other is extracorporeal hepatic resection (ECHR). [1][2][3][4][5][6][7] The benefit of liver transplantation is its simple surgical concept, and the benefits of ECHR are that it is immunosuppression-free and that organ donors are unnecessary. [1][2][3][4][5][6] The patient was a 39-year-old female referred to our hospital for possible living donor liver transplantation for her huge and multiple unresectable hemangiomas of the liver. Although she had undergone transcatheter arterial embolization 6 months previously, they showed an increase in size. At the time of referral, she demonstrated abdominal distention with shortness of breath. Her laboratory testing showed normal liver function tests, including a total bilirubin level of 1.3 mg/dL, an albumin level of 4.3 g/dL, and a prothrombin time of 13.6 seconds. A computed tomography scan of the abdomen showed 4 huge tumors (Fig. 1). This location of the tumors and their benign origin led us to choose ECHR rather than living donor liver transplantation after detailed informed consent was obtained. As is well known, the chance of receiving a liver graft from a deceased donor is almost zero in Japan. [7][8][9] The estimated autograft volume after ECHR was 590 g, representing a graft volume/standard liver volume ratio of 49.6% (Fig. 2).The patient was taken to the operating room, and laparotomy was performed (Fig. 3). The liver was severely enlarged, but the nontumor portion looked like normal hepatic parenchyma. After the dissection of the hilar structures at the mid-hilum, the portosystemic venovenous bypass, using reinforced venous cannulas (Edwards Life Sciences, Inc., Irvine, CA), was established from the inferior mesenteric vein with 16Fr and from the left saphenous vein with 15Fr to the left axillary vein with 14Fr. The patient was started on the bypass at the rate of 4 L/min with a stable circulatory condition. After the division of the proper hepatic artery, the total liver was mobilized from the diaphragm. The common hepatic duct was divided, the vascular clamps were applied and followed by division on the portal vein and suprahepatic and infrahepatic vena cava, and then the total hepatectomy was performed. The explanted liver was flushed with 3 L of normal saline followed by 3 L of University of Wisconsin solution. Intraoperative ultrasound was done on the backtable for the determination of the exact cutting line. After dissection of the vena cava from the dorsal liver with ligation of the short hepatic veins, the huge hemangiomas in segment 1, segment 2 to 3, caudal segment 4, and segment 6 to 7 were resected with a Cavitron ultrasonic surgical aspirator (Valleylab, Inc., Boulder, CO; Fig. 2). After resection, vascular and biliary leakage tests using an injection of University of Wisconsin solution were performed, and the leakage points were repaired with fine sutures. The actual weight of the whole explanted...

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Living donor liver transplantation for giant hepatic hemangioma with Kasabach-Merritt syndrome with a posterior segment graft

Cited by 54 publications

References 19 publications

Efficacy, safety and feasibility of ultrasound‐guided percutaneous microwave ablation for large hepatic hemangioma

Efficacy, safety and feasibility of ultrasound‐guided percutaneous microwave ablation for large hepatic hemangioma

Surgical Treatment of Giant Cavernous Hepatic Haemangiomas

Extracorporeal hepatic resection for unresectable giant hepatic hemangiomas

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