Combined hepatic resection with the inferior vena cava and diaphragm and reconstruction using an equine pericardial patch: Report of a case

Asai, Koji; Watanabe, Manabu; Miyata, Hiroshi; Osawa, Akihiro; Saito, Tomoaki; Kiribayashi, Takaharu; Enomoto, Toshiyuki; Nakamura, Yoichi; Okamoto, Yasushi; Saida, Yoshihisa; Kusachi, Shozo; Oharaseki, Toshiaki; Nagao, Jirō

doi:10.1007/s00595-011-4506-2

Cited by 10 publications

(2 citation statements)

References 22 publications

(44 reference statements)

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“…There are various surgical techniques, such as a partial IVC resection and direct closure or patch plasty, that can be used in cases of the direct invasion of liver tumors [11, 22–24]. However, it is sometimes necessary to interpose the IVC using an ePTFE graft with removable rings, although it is disadvantageous to replace the IVC using a graft because of the risk of the complications such as leakage of bile or pancreatic juice.…”

Section: Discussionmentioning

confidence: 99%

Combined resection of a tumor and the inferior vena cava: report of two cases

et al. 2012

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Tumor resection and caval tumor thrombectomy, with or without cavotomy and inferior vena cava (IVC) replacement are sometimes performed in patients with renal cell carcinoma (RCC) extending into the IVC or liver tumors invading the IVC. Two such cases were treated. Case 1: a 68-year-old female was transferred with a diagnosis of right RCC with tumor thrombus extending into the IVC. A plication was performed to prevent extension into the right atrium before the nephrectomy and cavotomy with removal of the tumor thrombus was accomplished, because the IVC was almost completely obstructed and the hemodynamics were stable during cross-clamping of the IVC. Case 2: a 37-year-old female was transferred with a diagnosis of a giant metastatic liver tumor. A trisegmentectomy with resection of the invaded IVC and IVC replacement was performed while the abdominal aorta was cross-clamped to maintain the hemodynamics. Therefore, abdominal aortic cross-clamping was convenient to maintain the hemodynamics when the IVC replacement was performed during IVC cross-clamping.

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Section: Discussionmentioning

confidence: 99%

Combined resection of a tumor and the inferior vena cava: report of two cases

et al. 2012

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“…In a hypothetical biocompatibility classification, this assessment puts the EP tissue well behind the bovine and porcine pericardium for high pressure cardiovascular and orthopaedic purposes. Conversely good results were obtained for venous conduits reconstruction [65], treatment of diabetic foot wounds [62] and tympanic perforation [66].…”

Section: Equine Pericardiummentioning

confidence: 99%

Biocompatibility Evaluation Criteria for Novel Xenograft Materials: Distribution and Quantification of Remnant Nucleic Acid and Alpha-Gal Epitope

Naso¹,

Andrea²,

Iop³

2013

J Stem Cell Res Ther

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Objective: Commercially decellularized xenogeneic scaffolds are currently employed as for the healing of diseased tissues. Strangely enough their use is permitted even in absence of any assessment of the elimination of xenogeneic cell material, as the alpha-Gal epitopes. In addition, the decellularization procedures are not monitored to prove the elimination of the calcific potential associated to the nucleic acids remnants. The currently treatment with glutaraldehyde is unable to grant a complete immuno-tolerance of implanted xenogeneic tissues, reducing but not eliminating the immunogenicity particularly for the alpha-Gal epitope (the major hindrance for the success of xenotransplantation). Recently, our group has extensively reported studies focused on the evaluation of biocompatibility properties of xenogeneic tissues. In this report we are performing this investigation and nucleic acid detection to novel xenogeneic tissues that have shown very promising preclinical/clinical results in different areas of application. Methods:The alpha-Gal quantification was conducted by an ELISA test previously developed and patented by our research team which involves the use of the monoclonal anti apha-Gal antibody M86. Immunofluorescence analysis was performed for the visual distribution of both xenogeneic epitopes and nucleic acids residues. Finally for the total DNA quantification a commercially available kit was adopted.Results: While the amount and distribution of the alpha-Gal epitopes was found different between the investigated biomaterials, the presence of nucleic acid remnants has been revealed as common feature, even in those tissues delivered as acellular by the manufacturer. Conclusion:Insufficient quantitative evaluations performed at preclinical level about the residual content of xenogeneic epitopes, detergents and nucleic acid materials in scaffolds have led to disappointing and disastrous results. The risk of these dramatic accidents reoccurring remains very high unless safety parameters, among which the complete removal of major xenogeneic determinants (alpha-Gal) and calcification-prone nucleic acid residues, are identified and introduced in manufacturing practices.

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