Use of a donor iliac vein graft for reconstruction of the inferior vena cava in liver transplantation for hepatoblastoma with caval extension.

Hort, Amy; Karpelowsky, Jonathan; Shun, Albert; Thomas, Gordon

Hort, Amy; Karpelowsky, Jonathan; Shun, Albert; Thomas, Gordon.

Afiliación

Hort A; The Department of Surgery, The Children's Hospital Westmead, Part of the Sydney Children's Hospital Network, Westmead, New South Wales, Australia.
Karpelowsky J; The Department of Surgery, The Children's Hospital Westmead, Part of the Sydney Children's Hospital Network, Westmead, New South Wales, Australia.
Shun A; Division of Child and Adolescent Health, University of Sydney, Sydney, New South Wales, Australia.
Thomas G; The Department of Surgery, The Children's Hospital Westmead, Part of the Sydney Children's Hospital Network, Westmead, New South Wales, Australia.

Pediatr Transplant ; 23(4): e13409, 2019 06.

Article en En | MEDLINE | ID: mdl-30946509

RESUMEN

Complete microscopic tumor resection is critical for successful treatment of hepatoblastoma, and this may include when liver transplantation is required. For tumors involving the IVC or PV, complete resection should include the involved IVC or PV to ensure full tumor clearance. When this is required, the venous reconstruction at transplant or post-excision can be challenging. We present the management of an 18-month-old girl with PRETEXT Stage IV (P, V, F) hepatoblastoma and IVC involvement, where native caval resection and reconstruction was required. The preoperative staging following neoadjuvant chemotherapy was POSTTEXT Stage IV (P, V, F). An orthotopic liver transplantation was performed using a left lateral segment graft from a deceased adult donor. With native hepatectomy, retrohepatic IVC resection from just above the hepatic venous confluence to just above the entry of the right adrenal vein was performed. For caval reconstruction, a venous graft from a deceased donor was used. The graft included the lower IVC with the right common iliac vein and a short stump of the left common iliac vein. The common iliac was a perfect size match for the IVC, and the three natural ostia matched the upper cava, lower cava, and the outflow from the donor left hepatic vein. The patient had an uneventful postoperative course and remains well and disease-free 2 years after transplant with continued patency of the reconstructed cava. When indicated, a donor iliac vein graft with its natural ostia should be considered in caval reconstruction for pediatric liver transplantation.

Asunto(s)

Hepatoblastoma/cirugía; Vena Ilíaca/trasplante; Neoplasias Hepáticas/cirugía; Trasplante de Hígado/métodos; Procedimientos de Cirugía Plástica/métodos; Vena Cava Inferior/cirugía; Supervivencia sin Enfermedad; Femenino; Hepatectomía/métodos; Venas Hepáticas/cirugía; Humanos; Lactante; Procedimientos Quirúrgicos Vasculares

Palabras clave

hepatoblastoma; liver transplantation; venous extension

Texto completo

Añadir a Mi BVS

Imprimir

XML

PubMed Links

Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Vena Cava Inferior / Trasplante de Hígado / Hepatoblastoma / Procedimientos de Cirugía Plástica / Vena Ilíaca / Neoplasias Hepáticas Límite: Female / Humans / Infant Idioma: En Revista: Pediatr Transplant Asunto de la revista: PEDIATRIA / TRANSPLANTE Año: 2019 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Dinamarca

Texto completo

Añadir a Mi BVS

Imprimir

XML

PubMed Links

Buscar en Google