No-Touch En Bloc Right Lobe Living-Donor Liver Transplantation with Inferior Vena Cava Replacement for Hepatocellular Carcinoma Close to Retrohepatic Inferior Vena Cava: Case Report

Moon, Deok‐Bog; Lee, S.-G.; Hwang, Shin; Kim, K.-H.; Ahn, Curie; Ha, Tae‐Yong; Song, Gi‐Won; Jung, Dong‐Hwan; Park, G.-C.; Namkoong, Jung-Man; Park, H.-W.; Park, Y.-H.; Park, C.-S.

doi:10.1016/j.transproceed.2013.08.052

Cited by 22 publications

(17 citation statements)

References 12 publications

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“…High correlation rate between SNAPP score and microvascular invasion, which is one of the most important predictors for the posttransplant recurrence, led us to perform specially designed LDLT procedures for the HCC patients with acceptable and high‐risk SNAPP scores to minimize the tumor recurrence such as “Hilar dissection first without mobilizing the liver having HCC” and “No‐touch en‐bloc total hepatectomy with IVC replacement.” 30 …”

Section: Discussionmentioning

confidence: 99%

Preoperative prediction score of hepatocellular carcinoma recurrence in living donor liver transplantation: Validation of SNAPP score developed at Asan Medical Center

Kim

Moon

Park

et al. 2021

American Journal of Transplantation

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The previously proposed scoring systems are not readily available because of the lack of simplicity for predicting hepatocellular carcinoma (HCC) recurrence. We aimed to develop and validate the new score system, which can predict HCC recurrence after living donor liver transplantation (LDLT) by using morphologic and biologic data. Predictors for HCC recurrence after LDLT were developed (n = 627) and validated (n = 806) in 1433 patients for whom we could collect information to date between 2007 and 2016 at Asan Medical center (AMC) to create the SNAPP score (tumor Size and Number, alpha‐fetoprotein [AFP], vitamin K absence‐II [PIVKA‐II], positron emission tomography [PET]). On logistic regression based on 3‐year recurrence‐free survival, the SNAPP factors were independently associated with HCC recurrence. The SNAPP score was highly predictive of HCC recurrence (C statistic, 0.920), and 5‐year post‐LT recurrence rates were significantly different between low, intermediate, and high SNAPP score groups. The performance of the SNAPP score (C‐index [95% confidence interval], 0.840 [0.801‐0.876]) on predicting tumor recurrence after LDLT was better than that of the New York/California, the Risk Estimation of Tumor Recurrence After Transplant (RETREAT), and the Model of Recurrence After Liver Transplant (MoRAL) score. The SNAPP score provides excellent prognostication after LDLT for HCC patients. Hence, we can help voluntary patients’ decisions about whether to undergo LDLT or not.

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Section: Discussionmentioning

confidence: 99%

Preoperative prediction score of hepatocellular carcinoma recurrence in living donor liver transplantation: Validation of SNAPP score developed at Asan Medical Center

Kim

Moon

Park

et al. 2021

American Journal of Transplantation

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“…If the IVC can be removed concurrently during LDLT operation, the extent of hepatectomy becomes comparable to that of DDLT. In clinical practice for LDLT, IVC replacement has been performed for the patients with HCCs closely located to the IVC or Budd-Chiari syndrome 123456…”

Section: Discussionmentioning

confidence: 99%

“…Replacement of the retrohepatic inferior vena cava (IVC) after concurrent resection of IVC and hepatocellular carcinoma (HCC)-containing liver is settled as an optional technique of living donor liver transplantation (LDLT) to cope with HCCs around the IVC 1234. This technique makes the resection extent of LDLT comparable to that of deceased-donor liver transplantation (DDLT).…”

Section: Introductionmentioning

confidence: 99%

Pediatric living donor liver transplantation with homograft replacement of retrohepatic inferior vena cava for advanced hepatoblastoma

Namgoong

Choi

Hwang

et al. 2019

Ann Hepatobiliary Pancreat Surg

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Replacement of the retrohepatic inferior vena cava (IVC) after concurrent resection of IVC and hepatocellular carcinoma-containing liver is settled as a feasible living donor liver transplantation (LDLT) technique to cope with tumors around the IVC. This technique makes LDLT comparable to deceased-donor liver transplantation (DDLT). In the current Korean setting, the common substitute for IVC is a Dacron graft for adult recipients. In contrast, such a synthetic graft cannot be used for pediatric patients because of ongoing growth. We present one pediatric LDLT case with IVC homograft replacement for advanced hepatoblastoma. The patient was a 8 year-old boy suffering from large multiple hepatoblastomas. The tumors encroached the retrohepatic IVC. Thus there was high risk of residual tumor cells at the IVC, if it was preserved. Thus, we decided to replace IVC at the time of LDLT. After waiting for >1 month, we finally obtained cold-stored IVC homograft and LDLT was performed with the mother's left liver. A 4 cm-long IVC allograft was anastomosed at the back table. The left liver graft with IVC interposition was implanted along standard procedure similar to DDLT. The patient recovered uneventfully and is undergoing scheduled adjuvant chemotherapy. We have performed >20 cases of IVC replacement in adult recipients with hepatocellular carcinoma or Budd-Chiari syndrome, but all vessel substitutes were synthetic, because sizable IVC homograft is unavailable. In pediatric recipients, various vein homografts such as iliac vein, IVC and other large-sized veins, can be used depending on body size of recipient and availability of vessel grafts.

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“…Replacement of the retrohepatic IVC after concurrent resection of hepatoblastoma and IVC or in Budd-Chiari syndrome is an optional technique of living donor LT, as in adult living donor LT for managing hepatocellular carcinoma around the IVC or Budd-Chiari syndrome [15][16][17][18]. In pediatric patients, synthetic vascular grafts cannot be used because of ongoing physical growth.…”

Section: Inferior Vena Cava Replacement During Pediatric Living Donor Liver Transplantationmentioning

confidence: 99%

Tailored techniques of graft outflow vein reconstruction in pediatric liver transplantation at Asan Medical Center

Hwang

Namgoong

2021

Ann Liver Transplant

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No-Touch En Bloc Right Lobe Living-Donor Liver Transplantation with Inferior Vena Cava Replacement for Hepatocellular Carcinoma Close to Retrohepatic Inferior Vena Cava: Case Report

Cited by 22 publications

References 12 publications

Preoperative prediction score of hepatocellular carcinoma recurrence in living donor liver transplantation: Validation of SNAPP score developed at Asan Medical Center

Preoperative prediction score of hepatocellular carcinoma recurrence in living donor liver transplantation: Validation of SNAPP score developed at Asan Medical Center

Pediatric living donor liver transplantation with homograft replacement of retrohepatic inferior vena cava for advanced hepatoblastoma

Tailored techniques of graft outflow vein reconstruction in pediatric liver transplantation at Asan Medical Center

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