Compared efficacy of University of Wisconsin and histidine-tryptophan-ketoglutarate solutions in ex-situ liver resection and autotransplantation for end-stage hepatic alveolar echinococcosis patients

Apaer, Shadike; Tuxun, Tuerhongjiang; Li, Tao; Aji, Tuerganaili; Payiziwula, Jiangduosi; Zhao, Jinming; Shao, Yingmei; Wen, Hao

doi:10.1016/j.hbpd.2019.07.001

Cited by 5 publications

(1 citation statement)

References 30 publications

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“…Up to now, more than 120 end-stage HAE cases have been treated by ERAT approach with ideal effect (19)(20)(21). Also, the application of artificial intelligence technique and new preserved solution study were also introduced into this area (22,23). However, the standard procedures of ERAT for end-stage HAE have not been established because of limited reported cases.…”

Section: Review Articlementioning

confidence: 99%

Current status of ex-vivo liver resection and autologous liver transplantation for end-stage hepatic alveolar echinococcosis

Yang

Deng

et al. 2020

Ann Palliat Med

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Hepatic alveolar echinococcosis (HAE) is a cosmopolitan zoonosis distribute widely in the northern hemisphere with high estimated 10-year mortality. Radical resection combined with oral albendazole administration are the major methods for HAE treatment, whereas most patients delayed diagnosis and treatment because which was considered as benign disease. For the cases with end-stage HAE could not be treated through conventional hepatectomy, allograft liver transplantation (LT) was regarded as a life-saving technique previously. However, graft shortage, high recurrence rate and long-term immunosuppressive therapy limited its utilization. Since the ex-vivo liver resection and autotransplantation (ERAT) procedure was first used in treating for end-stage HAE in 2011, there are more than 120 HAE cases patients were reported treating in this method up to now. Comparing with LT, ERAT needs neither an organ donor nor long term immunosuppressive therapy, and provide preferable overall survival rates. Based on the conventional ERAT procedure, some modification such as auxiliary partial autologous LT were introduced in the high selected end-stage HAE patients presently. However, the standard procedures for ERAT including surgical details and perioperative management have not been established because of limited reported cases. Also, the present ERAT experience for end-stage HAE treatment are all summarizes by the Chinese surgeon groups. For summarizing the knowledge and experience details, we reviewed present opinions about ERAT for end-stage HAE patients, and presented the future perspectives about this topic in this manuscript. We aimed at discussing the feasibility, indications, preparation, technical details, and postoperative outcomes of ERAT for HAE patients.

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Section: Review Articlementioning

confidence: 99%

Current status of ex-vivo liver resection and autologous liver transplantation for end-stage hepatic alveolar echinococcosis

Yang

Deng

et al. 2020

Ann Palliat Med

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Ex vivo liver resection and auto-transplantation as an alternative for the treatment of liver malignancies: Progress and challenges

Yang,

Lu,

Zhu

et al. 2024

Hepatobiliary & Pancreatic Diseases International

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Outcomes of ex vivo liver resection and autotransplantation: A systematic review and meta-analysis

Zawistowski

Nowaczyk

Jakubczyk

et al. 2020

Surgery

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Background: Many patients with hepatic tumors cannot benefit from resection owing to the difficult anatomic sites of their lesions. Some of these patients might be eligible for ex vivo liver resection and autotransplantation. This procedure consists of complete hepatectomy, extracorporeal liver resection, and autotransplantation of the remnant liver. Methods: Four databases were searched for studies reporting cases of ex vivo liver resection and autotransplantation. Outcomes of this procedure were evaluated by meta-analysis of proportions with random effects model and individual participant data analysis. Results: Fifty-three studies were assessed. Meta-analysis revealed an R0 resection rate of 93.4% (95% confidence interval: 81.0e97.9%, I 2 ¼ 0%), a frequency of major surgical complications of 24.5% (95% confidence interval, 16.9e34.3%, I 2 ¼ 26%), a 30-day mortality of 9.5% (95% confidence interval: 5.9e14.9%, I 2 ¼ 0%), and a 1-year survival of 78.4% (95% confidence interval: 62.2e88.8%, I 2 ¼ 64%). We were able to obtain the individual participant data in 244 patients; R0 resection was achieved in 98.6%, with no obvious difference between analyzed subgroups. The 30-day mortality and 1-year survivals were 7.9% and 82.1%, respectively. For groups with malignant and nonmalignant tumors, the 30-day mortalities were 11.3% vs. 6.3% (P ¼ .181), and 1-year survivals were 65.0% vs. 89.7% (P < .001). When comparing those with malignant versus those with nonmalignant lesions, major surgical complications occurred in 50.0% vs. 21.0%; P < .001). Regression analysis revealed that outcomes of patients with benign tumors were better compared with those with malignant tumors (1-year survival, odds ratio: 4.629; 95% confidence interval: 2.181e10.097, P < .001). Conclusion: Ex vivo liver resection and autotransplantation facilitates radical treatment in selected patients with conventionally unresectable hepatic tumors and normal liver function. The outcomes of treatment of malignant lesions appear to be less satisfactory.

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Compared efficacy of University of Wisconsin and histidine-tryptophan-ketoglutarate solutions in ex-situ liver resection and autotransplantation for end-stage hepatic alveolar echinococcosis patients

Cited by 5 publications

References 30 publications

Current status of ex-vivo liver resection and autologous liver transplantation for end-stage hepatic alveolar echinococcosis

Current status of ex-vivo liver resection and autologous liver transplantation for end-stage hepatic alveolar echinococcosis

Ex vivo liver resection and auto-transplantation as an alternative for the treatment of liver malignancies: Progress and challenges

Outcomes of ex vivo liver resection and autotransplantation: A systematic review and meta-analysis

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