Experience of liver transplantation for incurable alveolar echinococcosis: a 45-case European collaborative report

Koch, Stéphane; Bresson‐Hadni, Solange; Miguet, Jean-Philippe; Crumbach, Jean-Pierre; Gillet, M; Mantion, G.; Heyd, Bruno; Vuitton, Dominique-Angèle; Anne, Minello; Kurtz, Sabine

doi:10.1097/01.tp.0000054230.63568.79

Cited by 150 publications

(107 citation statements)

References 17 publications

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“…Liver transplantation has provided a life‐saving technique for patients with “unresectable” but not metastatic HAE lesions 11, 13, 14, 31, 32, 33, 34, 35. Several centers had reported their work, which was summarized in Table 4.…”

Section: Discussionmentioning

confidence: 99%

“…The most important advantage of an autologous graft over an artificial one is better biocompatibility, which greatly reduces the risk of graft rejection while reducing the postoperative anticoagulant therapy, thus reducing the possibility of postoperative bleeding 40, 41. In addition, the GSVs are easy to harvest, and their removal does not cause many adverse effects; all the preceding reasons make the GSV the ideal material for vascular reconstruction 26, 32, 35…”

Section: Discussionmentioning

confidence: 99%

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Novel techniques and preliminary results of ex vivo liver resection and autotransplantation for end-stage hepatic alveolar echinococcosis: A study of 31 cases

Yang

Qiu

Huang

et al. 2018

American Journal of Transplantation

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Ex vivo liver resection combined with autotransplantation is a recently introduced approach to cure end‐stage hepatic alveolar echinococcosis (HAE), which is considered unresectable by conventional radical resection due to echinococcal dissemination into the crucial intrahepatic conduits and adjacent structures. This article aims discuss the manipulation details and propose reasonable indications for this promising technique. All patients successfully underwent liver autotransplantation with no intraoperative mortality. The median weight of the autografts was 636 g (360‐1300 g), the median operation time was 12.5 hours (9.4‐19.5 hours), and the median anhepatic phase was 309 minutes (180‐ 460 minutes). Intraoperative blood loss averaged 1800 mL (1200‐6000 mL). Postoperative complications occurred in 13 patients during hospitalization; 5 patients experienced postoperative complications classified as Clavien‐Dindo grade III or higher, and 2 patients died of intraabdominal bleeding and acute cerebral hemorrhage, respectively. Twenty‐nine patients were followed for a median of 14.0 months (3‐42 months), and no HAE recurrence was detected. The technique requires neither an organ donor nor any postoperative immunosuppressant, and the success of the treatment relies on meticulous preoperative assessments and precise surgical manipulation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Novel techniques and preliminary results of ex vivo liver resection and autotransplantation for end-stage hepatic alveolar echinococcosis: A study of 31 cases

Yang

Qiu

Huang

et al. 2018

American Journal of Transplantation

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“…However, there are a number of studies that documented the outcomes for patients receiving a liver transplant because of advanced alveolar echinococcosis (45)(46)(47)211). A multicenter study performed in Europe showed an overall survival rate of 71% at 5 years, and in 58% of patients, there were no documented recurrences (211).…”

Section: Infections Caused By Echinococcus Sppmentioning

confidence: 99%

“…A multicenter study performed in Europe showed an overall survival rate of 71% at 5 years, and in 58% of patients, there were no documented recurrences (211).…”

Section: Infections Caused By Echinococcus Sppmentioning

confidence: 99%

Transmission of Tropical and Geographically Restricted Infections during Solid-Organ Transplantation

et al. 2008

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SUMMARY In recent years, the increasing number of donors from different regions of the world is providing a new challenge for the management and selection of suitable donors. This is a worldwide problem in most countries with transplantation programs, especially due to the increase in immigration and international travel. This paper elaborates recommendations regarding the selection criteria for donors from foreign countries who could potentially transmit tropical or geographically restricted infections to solid-organ transplant recipients. For this purpose, an extensive review of the medical literature focusing on viral, fungal, and parasitic infections that could be transmitted during transplantation from donors who have lived or traveled in countries where these infections are endemic has been performed, with special emphasis on tropical and imported infections. The review also includes cases described in the literature as well as risks of transmission during transplantation, microbiological tests available, and recommendations for each infection. A table listing different infectious agents with their geographic distributions and specific recommendations is included.

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“…Même si une ré-intervention a été COMMUNICATIONS nécessaire dans d'assez nombreux cas, surtout pour saignement, la transplantation est ainsi apparue comme une possibilité ultime de sauver ces malades. Des études ulté-rieures ont cependant montré (BRESSON-HADNI et al, 1999, KOCH et al 2003 que des métastases extra-hépa-tiques, initialement infra-cliniques, se développent trop souvent, grevant le pronostic à long terme. Ceci est sans doute à rapprocher des résultats expérimentaux obtenus par LIANCE et al (1992), qui ont établi que la ciclosporine (qui doit être poursuivie en permanence après la transplantation) déprime les réponses immunitaires spécifiques contre le parasite et favorise la croissance larvaire.…”

Section: Traitementunclassified

L'échinococcose alvéolaire : la place de l'homme

Houin¹

2004

bavf

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(communication présentée le 4 mars 2004)Des progrès significatifs dans le dépistage de l'échinococcose alvéolaire ont diminué le nombre de nouveaux malades dans les foyers européens, tandis que d'autres foyers sont maintenant mieux connus (par exemple en Chine). Mais cette zoonose ne peut être éradiquée et, dans des régions étendues, les réservoirs sauvages s'avèrent contaminés, faisant peser un risque sur la population humaine, jusqu'au coeur des villes. Diagnostiquée et donc traitée tôt, la maladie n'a plus le caractère inexorable qui reste le sien lorsqu'apparaissent les manifestations cliniques: des médicaments bloquent son évolution et la chirurgie permet des exérèses efficaces. Par contre, la transplantation hépatique qui avait soulevé de grands espoirs pour les patients porteurs de lésions évoluées, n'a pas confirmé son intérêt, du fait de la fréquence de métastases plus ou moins tardives, favorisées par l'immuno-dépression nécessitée par la greffe. Les connaissances en matière d'immunologie de cette parasitose ont beaucoup progressé et notamment contribué à l'amélioration des moyens de diagnostic. Mais elles ont aussi montré que l'homme est un mauvais hôte pour ce parasite et que bien souvent, il s'en débarrasse spontanément. Les mécanismes de cette guérison commencent à être connus et on peut espérer que des conséquences pratiques en soient tirées: définition de profils de sujets réceptifs ou de procédures « vaccinales », voire immuno-thérapeutiques. Mots

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Experience of liver transplantation for incurable alveolar echinococcosis: a 45-case European collaborative report

Cited by 150 publications

References 17 publications

Novel techniques and preliminary results of ex vivo liver resection and autotransplantation for end-stage hepatic alveolar echinococcosis: A study of 31 cases

Novel techniques and preliminary results of ex vivo liver resection and autotransplantation for end-stage hepatic alveolar echinococcosis: A study of 31 cases

Transmission of Tropical and Geographically Restricted Infections during Solid-Organ Transplantation

L'échinococcose alvéolaire : la place de l'homme

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