Approaches to reconstruction of inferior vena cava by ex vivo liver resection and autotransplantation in 114 patients with hepatic alveolar echinococcosis

Table 1 Clinical data of 114 alveolar echinococcosis patients treated by ex vivo liver resection and autotransplantation

Characteristics	Group A, n = 64	Group B, n = 43	Group C, n = 7	Total, n = 114	P value
Sex					0.12
Male	24	21	5	50
Female	40	22	2	64
Age in yr	36.9 ± 12.3	36.9 ± 10.5	30.8 ± 14.1	36.2 ± 11.8	0.29
Hepatitis B (+)	3	3	1	7	0.37
Intervention history					0.84
No	30	27	5	62
Hepatectomy	11	9	1	21
PTCD or ERCP	17	7	1	25
Albendazole history	16	11	0	27	0.31
Extrahepatic lesion					0.44
No	51	30	6	87
Lung	10	9	1	20
Kidney	1	1	1	3
Atrium	0	1	0	1
Brain	4	2	0	6
Bone	0	1	0	1

ERCP: Endoscopic retrograde cholangio-pancreatography; PTCD: Percutaneous transhepatic cholangial drainage.

Table 2 Intraoperative outcomes for 114 alveolar echinococcosis patients

	Group A, n = 64	Group B, n = 43	Group C, n = 7	Total, n = 114	P value
Operative time in h	16.7 ± 2.9	15.5 ± 3.2	16.9 ± 4.2	16.3 ± 3.1	0.56
Anhepatic phase in min	418.4 ± 108.3	383.9 ± 117.0	337.4 ± 108.7	394.0 ± 114.5	0.41
Blood loss in mL	1100 (400-15000)	1000 (400-8000)	2400 (800-14000)	1000 (400-15000)	0.07
Blood transfusion in U	5.8 ± 4.3	5.9 ± 3.9	14.8 ± 9.9	6.4 ± 6.2	0.90
Postoperative hospital stays in d	32.3 ± 19.8	26.7 ± 18.2	51.3 ± 29.4	36.4 ± 21.7	0.03
GLM in g	783.9 ± 233.5	908.6 ± 262.0	740.0 ± 235.6	828.3 ± 250.8	0.14
GLM/SLM, %	65.5 ± 18.9	74.1 ± 20.5	64.1 ± 17.8	68.6 ± 19.8	0.25
Materials (n)	Self-suture (52); Ligamentum teres hepatis (11); Internal jugular vein (1)	Artificial vascular (38); Allogeneic vascular (5)	Without reconstruction

GLM: Graft liver mass; SLM: Standard liver mass.

Table 3 Follow-up outcomes for 114 alveolar echinococcosis patients treated by ex vivo liver resection and autotransplantation

	Group A, n = 64	Group B, n = 43	Group C, n = 7	Total
Complications
Clavien-Dindo Grade IIb or lower	27 (42.2%)	19 (44.2%)	3 (42.9%)	49 (43.0%)
Clavien-Dindo Grade IIIa or higher	11 (17.2%)	7 (16.3%)	4 (57.1%)	22 (19.3%)
IVC related complications
IVC thrombosis	1 (1.6%)	5 (11.6%)	0	6 (5.3%)
IVC stenosis	10 (15.6%)	2 (4.7%)	0	12 (10.5%)
Liver related complications
Biliary leakage	9 (14.1%)	7(16.3%)	3 (42.9%)	19 (16.7%)
Budd-chiari syndrome	1(1.6%)	1(2.33%)	0	2 (1.8%)
Hepatic dysfunction	8 (12.5%)	3(7.0%)	1 (14.3%)	12 (10.5%)
Pleural effusion	19	10	0	29
Ascites	8	6	3	17
Renal failure	3	0	0	3
Bone marrow suppression	0	0	1	1
Abdominal infection	2	2	1	5

IVC: Inferior vena cava.

Table 4 Literature summary of inferior vena cava reconstruction in ex vivo liver resection and autotransplantation

Ref.	Number of cases	IVC reconstructed	Reconstructed type	Follow up time in mo	Effect of reconstruction
Wen et al[28], 2011	1	No	-	-	-
Hwang et al[34], 2012	6	No	-	-	-
Lei et al[15], 2015	1	Yes	III	12	Satisfied
Wen et al[29], 2016	15	No	-	-	-
Shen et al[14], 2018	45	Yes	I and II	22	Satisfied
Aji et al[13], 2018	69	No	-	-	-
Du et al[37], 2019	8	Yes	III	23	Satisfied
Ran et al[32], 2019	1	Yes	III	-	-
Kong et al[38], 2019	2	No	-	-	-
Yang et al[39], 2020	5	Yes	III	18	Unsatisfied
Zhang et al[40], 2020	1	Yes	II	6	Satisfied
Ran et al[41], 2021	7	Yes	III	64	Unsatisfied
Jiang et al[33], 2021	6	Yes	I	17.5	Satisfied

IVC: Inferior vena cava. Reconstructed type: I: Retrohepatic inferior vena cava (RHIVC) self-repairing reconstruction; II: RHIVC replacement; III: RHIVC resection without reconstruction; -: There is no related description.