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Reyimu A, Tiemin J, Yingmei S, Xuepeng Z, Wenjiang G, Yuhao D, Halimulati D, Ababokeli W, Tuerganaili A, Hao W. Treatment of Cavernous Transformation of Portal Vein Caused by Hepatic Cystic Echinococcosis Using Ex Vivo Liver Resection and Autotransplantation. Ann Transplant 2024; 29:e942358. [PMID: 38622855 PMCID: PMC11032082 DOI: 10.12659/aot.942358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 12/19/2023] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Hepatic cystic echinococcosis (HCE) is a frequently overlooked parasitic liver disease, for which the commonly recommended treatment is radical resection. However, this approach is often associated with severe comorbidities such as HBV/HCV, cirrhosis, and hepatic carcinoma, among others. CASE REPORT In this report, we present a case successfully managed by ex vivo liver resection and autologous liver transplantation (ELRA). In the described case, ex vivo resection was not feasible due to recurrent lesions and infections invading the portal vein, which resulted in portal vein cavernous transformation. CONCLUSIONS Through this paper, we aim to detail the treatment process, showcasing the feasibility and advantages of ELRA. Additionally, we propose a novel approach for the treatment of this disease, while emphasizing the importance of radical resection surgery to prevent long-term complications.
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Affiliation(s)
- Ayidu Reyimu
- Department of Hepatobiliary Surgery, People’s Hospital of Xinjiang Bayingolin Mongol Autonomous Prefecture, Korla, Xinjiang, PR China
| | - Jiang Tiemin
- Department of Hepatobiliary & Hydatid Diseases, Digestive & Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, PR China
- State Key Laboratory of Pathogenesis, Prevention and Management of High-Incidence Diseases in Central Asia, Xinjiang Medical University, Urumqi, Xinjiang, PR China
| | - Shao Yingmei
- Department of Hepatobiliary & Hydatid Diseases, Digestive & Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, PR China
- State Key Laboratory of Pathogenesis, Prevention and Management of High-Incidence Diseases in Central Asia, Xinjiang Medical University, Urumqi, Xinjiang, PR China
| | - Zhu Xuepeng
- Department of Hepatobiliary Surgery, People’s Hospital of Xinjiang Bayingolin Mongol Autonomous Prefecture, Korla, Xinjiang, PR China
| | - Guo Wenjiang
- Department of Hepatobiliary Surgery, People’s Hospital of Xinjiang Bayingolin Mongol Autonomous Prefecture, Korla, Xinjiang, PR China
- Department of Hepatobiliary & Hydatid Diseases, Digestive & Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, PR China
| | - Du Yuhao
- Department of Hepatobiliary Surgery, People’s Hospital of Xinjiang Bayingolin Mongol Autonomous Prefecture, Korla, Xinjiang, PR China
| | - Dilixiati Halimulati
- Department of Hepatobiliary Surgery, People’s Hospital of Xinjiang Bayingolin Mongol Autonomous Prefecture, Korla, Xinjiang, PR China
| | - Wusiman Ababokeli
- Department of Hepatobiliary Surgery, People’s Hospital of Xinjiang Bayingolin Mongol Autonomous Prefecture, Korla, Xinjiang, PR China
| | - Aji Tuerganaili
- Department of Hepatobiliary & Hydatid Diseases, Digestive & Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, PR China
- State Key Laboratory of Pathogenesis, Prevention and Management of High-Incidence Diseases in Central Asia, Xinjiang Medical University, Urumqi, Xinjiang, PR China
| | - Wen Hao
- Department of Hepatobiliary & Hydatid Diseases, Digestive & Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, PR China
- State Key Laboratory of Pathogenesis, Prevention and Management of High-Incidence Diseases in Central Asia, Xinjiang Medical University, Urumqi, Xinjiang, PR China
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Gravetz A. Portal vein-variceal anastomosis for portal vein inflow reconstruction in orthotopic liver transplantation: A case report and review of literature. World J Transplant 2022; 12:204-210. [PMID: 36051454 PMCID: PMC9331412 DOI: 10.5500/wjt.v12.i7.204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 04/06/2022] [Accepted: 06/17/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Portal vein thrombosis (PVT) is a frequent complication occurring in 5% to 26% of cirrhotic patients candidates for liver transplantation (LT). In cases of extensive portal and or mesenteric vein thrombosis, complex vascular reconstruction of the portal inflow may become necessary for a successful orthotopic LT (OLT).
CASE SUMMARY A 54-year-old male with history of cirrhosis secondary to schistosomiasis complicated with extensive portal and mesenteric vein thrombosis and severe portal hypertension who underwent OLT with portal vein-left gastric vein anastomosis.
CONCLUSION We review the various types of PVT, the portal venous inflow reconstruction techniques.
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Affiliation(s)
- Aviad Gravetz
- Department of Transplantation, Rabin Medical Center, Beilinson Hospital, Petach-Tikva 4941492, Israel
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Wei B, Huang Z, Tang C. Optimal Treatment for Patients With Cavernous Transformation of the Portal Vein. Front Med (Lausanne) 2022; 9:853138. [PMID: 35402447 PMCID: PMC8987530 DOI: 10.3389/fmed.2022.853138] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 02/21/2022] [Indexed: 01/10/2023] Open
Abstract
Cavernous transformation of the portal vein (CTPV) is a sequela of extrahepatic and/or intrahepatic portal vein obstruction caused by a combination of local and risk factors. It was ever taken as a relatively rare disease due to its scant literature, which was mainly based on clinical series and case reports. CTPV often manifests as gastroesophageal variceal bleeding, splenomegaly, and portal biliopathy after the long-term insidious presentation. It is unable for CTPV to be recanalized with anticoagulation because it is a complete obstruction of the mesentericoportal axis. Endoscopic therapy is mainly used for temporary hemostasis in acute variceal bleeding. Meso-Rex shunting characterized by portal-flow-preserving shunts has been widely performed in children with CTPV. The multitude of complications associated with CTPV in adults can be effectively addressed by various interventional vascular therapies. With the ubiquity of radiological examinations, optimal treatment for patients with CTPV becomes important. Multivisceral transplantation, such as liver-small intestinal transplantation, may be lifesaving and should be considered for patients with diffuse mesenteric venous thrombosis.
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Affiliation(s)
- Bo Wei
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
| | - Zhiyin Huang
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
| | - Chengwei Tang
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Chengdu, China
- *Correspondence: Chengwei Tang
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