Recurrence of Liver Transplantation Combined With Lung and Diaphragm Resection for Alveolar Echinococcosis: A Case Report

Pang, Chuan; Chu, Ya-Chiung

doi:10.1016/j.transproceed.2015.06.013

Cited by 11 publications

(5 citation statements)

References 8 publications

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“…Current, further exploration is needed to uncover metastatic features and organ tropism of HAE [ 4 , 13 ]. Still, liver transplantation serves as an ultimate solution for advanced inoperable HAE [ 14 ], but it has higher mortality and recurrence versus resection alone [ 5 ]. By contrast, ELRA offers a novel approach for unresectable HAE, addressing limitations of allotransplantation by avoiding donor organs or immunosuppression [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Liver autotransplantation and atrial reconstruction on a patient with multiorgan alveolar echinococcosis: a case report

Ruze,

Jiang,

Zhang

et al. 2024

BMC Infect Dis

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Background Alveolar echinococcosis (AE) primarily affects the liver and potentially spreads to other organs. Managing recurrent AE poses significant challenges, especially when it involves critical structures and multiple major organs. Case presentation We present a case of a 59-year-old female with recurrent AE affecting the liver, heart, and lungs following two previous hepatectomies, the hepatic lesions persisted, adhering to major veins, and imaging revealed additional diaphragmatic, cardiac, and pulmonary involvement. The ex vivo liver resection and autotransplantation (ELRA), first in human combined with right atrium (RA) reconstruction were performed utilizing cardiopulmonary bypass, and repairs of the pericardium and diaphragm. This approach aimed to offer a potentially curative solution for lesions previously considered inoperable without requiring a donor organ or immunosuppressants. The patient encountered multiple serious complications, including atrial fibrillation, deteriorated liver function, severe pulmonary infection, respiratory failure, and acute kidney injury (AKI). These complications necessitated intensive intraoperative and postoperative care, emphasizing the need for a comprehensive management strategy in such complicated high-risk surgeries. Conclusions The multidisciplinary collaboration in this case proved effective and yielded significant therapeutic outcomes for a rare case of advanced hepatic, cardiac, and pulmonary AE. The combined approach of ELRA and RA reconstruction under extracorporeal circulation demonstrated distinct advantages of ELRA in treating complex HAE. Meanwhile, assessing diaphragm function during the perioperative period, especially in patients at high risk of developing pulmonary complications and undergoing diaphragmectomy is vital to promote optimal postoperative recovery. For multi-resistant infection, it is imperative to take all possible measures to mitigate the risk of AKI if vancomycin administration is deemed necessary.

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Section: Discussionmentioning

confidence: 99%

Liver autotransplantation and atrial reconstruction on a patient with multiorgan alveolar echinococcosis: a case report

Ruze,

Jiang,

Zhang

et al. 2024

BMC Infect Dis

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“…Although there is no doubt that the first choice for treatment of HAE is surgical resection, 1,2,24,25 even after curative resection, recurrence can occur. [24][25][26] It seems to be related to invisible remnant parasitic tissue in the liver. Therefore, 2-year chemotherapy with albendazole is recommended for most HAE patient even after curative resection.…”

Section: Discussionmentioning

confidence: 99%

Management of Advanced Hepatic Alveolar Echinococcosis: Report of 42 Cases

Qu¹,

Guo²,

Sheng³

et al. 2017

The American Society of Tropical Medicine and Hygiene

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Abstract. Radical resection is the first choice for hepatic alveolar echinococcosis (HAE). However, many patients with advanced HAE have no chance to be treated with curative resection owing to the long clinical latency. This study aimed to evaluate the necessity of aggressive operations, like palliative resection and orthotopic liver transplantation (OLT), in the management of advanced HAE. A retrospective study analyzed 42 patients with advanced HAE treated with palliative resection (N = 15), palliative nonresective procedures (N = 13), OLT (N = 3), or albendazole therapy alone (N = 11). The patients' condition before treatments was comparable among all the four groups. The overall 1-year, 3-year, and 5-year survival rates of the 42 cases were 81.0%, 45.2%, and 23.8%, respectively. No event occurred to end the follow-up during the 5-year observation period except death. The survival time (median ± standard error) of the palliative resection group (3.6 ± 1.4 years) was longer than that of the palliative nonresective procedures group (1.5 ± 0.2) and the albendazole therapy-alone group (1.0 ± 0.4). The 5-year survival rates after palliative resection and liver transplantation were 40.0% and 66.7%, compared with only 7.7% and 9.1% after palliative nonresective procedures or albendazole therapy alone. Therefore, we concluded that aggressive treatment with a multimodality strategy could contribute to prolonged survival in patients with advanced HAE. Moreover, the prognosis of the patients who received albendazole therapy alone or palliative nonresective procedures is poor.

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“…Considering the advanced disease stage and previous surgical interventions in patients undergoing LT, the operative procedure is often technically challenging. Direct involvement of the adjacent organs may require extensive resection during the LT . Technical difficulties may arise, especially in living‐donor LT .…”

Section: Discussionmentioning

confidence: 99%

Alveococcosis of the liver – strategy of surgical treatment with special focus on liver transplantation

Patkowski

Kotulski

Remiszewski

et al. 2016

Transplant Infectious Dis

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Recurrence of Liver Transplantation Combined With Lung and Diaphragm Resection for Alveolar Echinococcosis: A Case Report

Cited by 11 publications

References 8 publications

Liver autotransplantation and atrial reconstruction on a patient with multiorgan alveolar echinococcosis: a case report

Liver autotransplantation and atrial reconstruction on a patient with multiorgan alveolar echinococcosis: a case report

Management of Advanced Hepatic Alveolar Echinococcosis: Report of 42 Cases

Alveococcosis of the liver – strategy of surgical treatment with special focus on liver transplantation

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