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

Abstract

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.

SOD2 overexpression in bone marrow‑derived mesenchymal stem cells ameliorates hepatic ischemia/reperfusion injury

“…Accumulating evidence has indicated that nerve cells, adipocytes, osteoblasts and stem cell transplantation therapy are conducive to tissue damage repair and functional recovery ( 32 – 34 ). HIRI is a common pathological event during liver surgery, and is widely accepted as a common and inevitable complication during liver resection and liver transplantation, particularly in patients with end-stage liver disease ( 35 ). Moreover, the commonly used treatment methods for this include liver resection and liver transplantation, and thus, a method to reduce the I/R injury of the liver during surgery will be of great significance to the clinical treatment of liver diseases ( 36 ).…”

Long-term Follow-up of a Patient with Portal Hypertension and Hepatic Failure Due to Hepatic Hydatid Disease

“…In terms of treatment for hepatic hydatid disease, surgery remains the primary approach for the treatment of hepatic AE; radical resection combined with oral albendazole/mebendazole administration is a common method of treating AE ( 19 ). However, most patients experience a delayed diagnosis, and liver transplantation has been necessary to cure some patients ( 20 , 21 ). In our patient, the liver cysts had already spread, and curative treatment could not be performed at the initial suspicion of echinococcosis; only the ascites could be treated.…”

Re-Endothelialization of Decellularized Liver Scaffolds: A Step for Bioengineered Liver Transplantation

“…In the anhepatic phase of this human operation, the native liver is completely removed from the abdominal cavity for treatment, an artificial vascular graft is applied to temporarily reconstruct the IVC, and a portocaval shunt is established ( Yang et al, 2018 ). The reported anhepatic phase in alveolar echinococcosis ranges from 104 to 879 min ( Aji et al, 2018 ; Yang et al, 2018 ; Yang et al, 2020 ). According to the anhepatic phase of human reality viewpoint and comparing it with the survival data of our study, our rBELs would be efficient for sustaining physical perfusion phase in the absence of visible clots if they are used for this purpose in the future.…”