Letters To The Editor
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World J Gastroenterol. Mar 21, 2010; 16(11): 1425-1426
Published online Mar 21, 2010. doi: 10.3748/wjg.v16.i11.1425
Liver transplantation for polycystic liver and massive hepatomegaly
Salvatore Gruttadauria, Fabrizio di Francesco, Bruno Gridelli
Salvatore Gruttadauria, Fabrizio di Francesco, Bruno Gridelli, Mediterranean Institute for Transplant and Advanced Specialized Therapies, University of Pittsburgh Medical Center in Italy, Via E. Tricomi N. 1, Palermo 90127, Italy
Salvatore Gruttadauria, Bruno Gridelli, Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15213, United States
Author contributions: Gruttadauria S performed the operation and wrote the paper; di Francesco F collected the data and the literature back-ground; Gridelli B reviewed the paper.
Correspondence to: Salvatore Gruttadauria, MD, Associate Professor, Mediterranean Institute for Transplant and Advanced Specialized Therapies, University of Pittsburgh Medical Center in Italy, Via E. Tricomi N. 1, Palermo 90127, Italy. sgruttadauria@ismett.edu
Telephone: +39-91-2192111  Fax: +39-91-2192400
Received: December 16, 2009
Revised: January 15, 2010
Accepted: January 22, 2010
Published online: March 21, 2010
Abstract

Liver tumor and other benign liver diseases such as polycystic liver disease can cause massive hepatomegaly and may represent an indication for liver transplantation (LT) in some instances. In this setting, LT can be extremely difficult and challenging due to its decreased mobility and access to vascular supply. Benefit from either a right or a left partial liver resection during the transplant procedure has been advocated to safely accomplish the hepatectomy of the native liver. Although we believe that partial hepatectomy adds some risk to intra-operative bleeding, we alternatively advise a different approach. We have a successful experience with LT in 6 massive hepatomegaly patients due to giant liver lesions. All the transplant procedures were performed without intermediate partial liver resection, showing that selective use of veno-venous bypass can play a significant role in the treatment of massive hepatomegaly.

Keywords: Liver transplantation; Massive hepatomegaly; Polycystic liver