Liver transplantation for hepatic alveolar echinococcosis: literature review and three new cases

Aliakbarian, Mohsen; Tohidinezhad, Fariba; Eslami, Saeid; Akhavan-Rezayat, Kambiz

doi:10.1080/23744235.2018.1428823

Cited by 27 publications

(24 citation statements)

References 27 publications

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“…Besides, achieving 2 cm resection margin for every single lesion is not possible in most advanced cases as recommended [3,4,28,30]. For excessive vascular in ltrated lesion or with severe comorbidities, only liver transplantation or ex vivo liver resection and autotransplantation could be selected from the perspective surgical treatment [11,[31][32][33][34][35][36][37][38][39][40]. Our data indicated that, different lesion types had different immune cell in ltrated belt.…”

Section: Discussionmentioning

confidence: 99%

Quantitative evaluation of range and metabolic activity of hepatic alveolar echinococcosis lesion microenvironment using PET/CT and multi-site sampling method

Aini

Yimingjiang

Yasen

et al. 2020

Preprint

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Background: Alveolar echinococcosis (AE) lesion microenvironment (LME) is crucial site where parasite-host interactions happen and of great significance during surgery and obtaining liver samples for basic research targeting immunology. However, little is known about quantification of LME range and its’ metabolic activity regarding different lesion types.Methods: A prospective analysis of LME from consecutive surgical AE cases with relevant imaging results was performed. Patients (n=39) received abdominal computed tomography (CT) and position emission tomography/computed tomography using 18F-fluodeoxyglucose (18F-FDG-PET/CT) within one week prior to surgery. Tumor to background ratios (TBRs) of standard uptake value (SUV) in PET/CT was calculated for corresponding LME regions. Multi-site sampling method (MSS, n=26) was introduced to obtain histological slides from LME at different levels off the lesion to evaluate immune cell infiltrative ranges quantitatively. At last, data was statistically analyzed from the perspective of different lesion types.Results: Altogether six major lesion categories have been identified based on different morphology and calcification pattern (A: non-calcified uniform density lesion; B: diffuse calcified solid lesion; C: half necrotic and half solid lesion with minor calcification; D: half necrotic and half solid lesion with obvious calcification; E: subtotal necrotic lesion with minor calcification; F: total necrotic lesion with obvious calcification). Statistical significances were resulted from TBRs calculation (A>B, A>D, A>F, B<C, B<E, A+C+E>B+D+F, etc.). Less calcified lesions were evidenced with higher TBRs, however, not much was valuable for necrosis. The 95% CI of LME ranges were (10.0, 12.1) mm and (9.9, 14.0) mm by PET/CT and MSS. And, weak regressions between TBRs and LME ranges indicated by PET/CT or MSS (r2 respectively were 0.2436 and 0.3171) were observed.Conclusions: PET/CT showed distinct TBRs for different lesion types with heterogenic calcification. PET/CT and MSS had similar discoverability for LME ranges, which also varied among different lesion types. Higher activity meant wider LME range within certain limit. This pioneering study would be able to provide references for both surgical removal of lesions and sample acquisitions more accurately for basic research targeted to immunology.

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Section: Discussionmentioning

confidence: 99%

Quantitative evaluation of range and metabolic activity of hepatic alveolar echinococcosis lesion microenvironment using PET/CT and multi-site sampling method

Aini

Yimingjiang

Yasen

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Besides, achieving 2 cm resection margin for every single lesion is not possible in most advanced cases as recommended [3,4,28,30]. For excessive vascular infiltrated lesion or with severe comorbidities, only liver transplantation or ex vivo liver resection and autotransplantation could be selected from the perspective surgical treatment [11,[31][32][33][34][35][36][37][38][39][40]. Our data indicated that, different lesion types had different immune cell infiltrated belt.…”

Section: Discussionmentioning

confidence: 99%

Quantitative evaluation of range and metabolic activity of hepatic alveolar echinococcosis lesion microenvironment using PET/CT and multi-site sampling method

Aini

Yimingjiang

Yasen

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Alveolar echinococcosis (AE) lesion microenvironment (LME) is crucial site where parasite-host interactions happen and of great significance during surgery and obtaining liver samples for basic research targeting immunology. However, little is known about quantification of LME range and its’ metabolic activity regarding different lesion types. Materials and Methods: A prospective analysis of LME from consecutive surgical AE cases with relevant imaging results was performed. Patients (n=39) received abdominal computed tomography (CT) and position emission tomography/computed tomography using 18F-fluodeoxyglucose (18F-FDG-PET/CT) within one week prior to surgery. Tumor to background ratios (TBRs) of standard uptake value (SUV) in PET/CT was calculated for corresponding LME regions. Multi-site sampling method (MSS, n=26) was introduced to obtain histological slides from LME at different levels off the lesion to evaluate immune cell infiltrative ranges quantitatively. At last, data was statistically analyzed from the perspective of different lesion types. Results: Altogether six major lesion categories have been identified based on different morphology and calcification pattern (A: non-calcified uniform density lesion; B: diffuse calcified solid lesion; C: half necrotic and half solid lesion with minor calcification; D: half necrotic and half solid lesion with obvious calcification; E: subtotal necrotic lesion with minor calcification; F: total necrotic lesion with obvious calcification). Statistical significances were resulted from TBRs calculation (A>B, A>D, A>F, BB+D+F, etc.). Less calcified lesions were evidenced with higher TBRs, however, not much was valuable for necrosis. The 95% CI of LME ranges were (10.0, 12.1) mm and (9.9, 14.0) mm by PET/CT and MSS. And, weak regressions between TBRs and LME ranges indicated by PET/CT or MSS (r2 respectively were 0.2436 and 0.3171) were observed. Conclusions: PET/CT showed distinct TBRs for different lesion types with heterogenic calcification. PET/CT and MSS had similar discoverability for LME ranges, which also varied among different lesion types. Higher activity meant wider LME range within certain limit. This pioneering study would be able to provide references for both surgical removal of lesions and sample acquisitions more accurately for basic research targeted to immunology.

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“…Following this, medical treatment is continued for a while (12). Liver transplantation is a lifesaving in the treatment with hepatic hilum involvement, bile ducts and vascular invasion where liver resection or surgical treatment is difficult (13).…”

Section: Discussionmentioning

confidence: 99%

The investigation of clinical and radiological findings of hepatic alveolar cyst hydatid disease

Koç¹

2018

Ann Med Res

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The aim of this study is to investigate the clinical and radiological findings of hepatic alveolar hydatid cyst diagnosed in our clinic. Material and Methods: Records of patient files with histological diagnosis of hepatic alveolar hydatid cyst between March 2013 and February 2018 were retrospectively reviewed. Fifteen cases were included in the study. Nine of the cases were males (60 %) and 6 were females (40 %). Their ages ranged from 27 to 62 with a mean age of 41 ± 7.3 years. Clinical and laboratory findings and radiological imaging findings of the cases were investigated and recorded. Results: The most common symptoms were right upper quadrant pain (75 %), jaundice (24 %), fever (13 %) and weight loss (12 %). The most common finding in physical examinations was hepatomegaly (96 %). AST, ALT, and ALP values increased 3-4 times. Bilirubin values were generally increased (0.8-21.2 mg/dL). Abdominal ultrasonography (US) was described as a mass lesion with irregularly border, heterogeneous echogenicity, which consisted of the most solid component. It was located in the right liver lobe (82 %). Multislice Computed Tomography (MSCT) and Magnetic Resonance Imaging (MRI) findings supported the US findings. There was no contrast material involvement in the lesion. Diffusion MRI showed mild diffusion restriction somewhere. Conclusions: Alveolar echinococcosis frequently confused with other malignant liver lesions. Early diagnosis of the disease is very important in terms of treatment. Immunologic tests and biopsy are helpful in diagnosis. Radiological findings have an important role and contribution in the diagnosis of the disease.

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Liver transplantation for hepatic alveolar echinococcosis: literature review and three new cases

Abstract: LT combined with pre- and post-transplant benzimidazole therapy appears to be feasible and effective for patients with fatal HAE.

Cited by 27 publications

References 27 publications

Quantitative evaluation of range and metabolic activity of hepatic alveolar echinococcosis lesion microenvironment using PET/CT and multi-site sampling method

Quantitative evaluation of range and metabolic activity of hepatic alveolar echinococcosis lesion microenvironment using PET/CT and multi-site sampling method

Quantitative evaluation of range and metabolic activity of hepatic alveolar echinococcosis lesion microenvironment using PET/CT and multi-site sampling method

The investigation of clinical and radiological findings of hepatic alveolar cyst hydatid disease

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