Yang HR, Thorat A, Gesakis K, Li PC, Kiranantawat K, Chen HC, Jeng LB. Living donor liver transplantation with abdominal wall reconstruction for hepatocellular carcinoma with needle track seeding. World J Transplant 2015; 5(4): 360-365 [PMID: 26722665 DOI: 10.5500/wjt.v5.i4.360]
Corresponding Author of This Article
Long-Bin Jeng, Professor, Chief, Department of Surgery and Organ Transplantation Center, China Medical University Hospital, 2, Yuh-Der Road, Taichung 40447, Taiwan. otc@mail.cmuh.org.tw
Research Domain of This Article
Transplantation
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Horng-Ren Yang, Ashok Thorat, Ping-Chun Li, Long-Bin Jeng, Department of Surgery and Organ Transplantation Center, China Medical University Hospital, Taichung 40447, Taiwan
Horng-Ren Yang, Ping-Chun Li, Long-Bin Jeng, College of Medicine, China Medical University, Taichung 40447, Taiwan
Kanellos Gesakis, Kidakorn Kiranantawat, Hung Chi Chen, Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung 40447, Taiwan
Author contributions: All authors contributed to this paper.
Institutional review board statement: This is to state that the present retrospective study was approved by the IRB of the China medical university hospital.
Informed consent statement: Informed consent was obtained prior to initiation of procedure.
Conflict-of-interest statement: No conflict of interests among the authors.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Long-Bin Jeng, Professor, Chief, Department of Surgery and Organ Transplantation Center, China Medical University Hospital, 2, Yuh-Der Road, Taichung 40447, Taiwan. otc@mail.cmuh.org.tw
Telephone: +886-04-22052121 Fax: +886-04-22029083
Received: June 27, 2015 Peer-review started: July 12, 2015 First decision: August 26, 2015 Revised: October 17, 2015 Accepted: November 10, 2015 Article in press: November 11, 2015 Published online: December 24, 2015 Processing time: 178 Days and 17.6 Hours
Abstract
Malignant cell seeding in subcutaneous tissues along the needle track and/or percutaneous biliary drainage catheters is rare complication, but pose various technical issues in planning surgical treatment of such patients. If underlying primary hepatic malignancy can be treated, an aggressive resection of subcutaneous tissue bearing cancer cell with subsequent abdominal wall reconstruction has been sporadically reported. But, when hepatic resection is not possible due to underlying advanced cirrhosis, liver transplantation along with abdominal wall resection and subsequent reconstruction remains only feasible option. Herein, we describe our successful experience of living donor liver transplantation for hepatocellular carcinoma with full-thickness abdominal wall resection bearing the tumor seeding followed by reconstruction in single stage surgery.
Core tip: Metastatic cell seeding can rarely occur in hepatocellular carcinoma secondary to procedures such as liver biopsy and percutaneous biliary drainage catheters. Abdominal resection bearing the malignant cells with resection of underlying liver cancer is the only curative option. But, if the resection of the liver is not possible due to poor underlying liver functions, liver transplantation (LT) can still be performed with excision of the subcutaneous malignant track. In this case report we are presenting our successful experience with living donor LT combined with abdominal wall resection and reconstruction using thigh myocutaneous pedicle flap in a single stage surgery.
