Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 16, 2023; 11(23): 5602-5609
Published online Aug 16, 2023. doi: 10.12998/wjcc.v11.i23.5602
Complex inferior vena cava reconstruction during ex vivo liver resection and autotransplantation: A case report
Jiayidaer Humaerhan, Tie-Min Jiang, Tuerganaili Aji, Ying-Mei Shao, Hao Wen
Jiayidaer Humaerhan, Tie-Min Jiang, Tuerganaili Aji, Ying-Mei Shao, Hao Wen, Department of Hepatobiliary & Hydatid Diseases, Digestive & Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
Jiayidaer Humaerhan, Tie-Min Jiang, Tuerganaili Aji, Hao Wen, State Key Laboratory of Pathogenesis, Prevention and Management of High Incidence Diseases in Central Asia, The First Clinical Medical College of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
Ying-Mei Shao, Xinjiang Clinical Research Center for Echinococcosis and Hepatobiliary Diseases, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
Author contributions: Humaerhan J and Jiang TM contributed to manuscript writing and editing, and data collection; Aji T and Shao YM contributed to data analysis; Wen H contributed to conceptualization and supervision; all authors have read and approved the final manuscript.
Supported by Key Laboratory Opening Topic Fund Subsidization: The Regulation of Sympathetic Nerve in Liver Regeneration in Hepatic Alveolar Echinococcosis, No. 2021D04024.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hao Wen, PhD, Chief Doctor, State Key Laboratory of Pathogenesis, Prevention and Management of High Incidence Diseases in Central Asia, The First Clinical Medical College of Xinjiang Medical University, No. 137 Leiyueshan South Road, Xincheng District, Urumqi 830054, Xinjiang Uygur Autonomous Region, China. dr.wenhao@163.com
Received: May 24, 2023
Peer-review started: May 24, 2023
First decision: June 19, 2023
Revised: July 1, 2023
Accepted: July 17, 2023
Article in press: July 17, 2023
Published online: August 16, 2023
Processing time: 83 Days and 13.7 Hours
Abstract
BACKGROUND

Ex vivo liver resection and autotransplantation (ELRA) is an essential approach for treating patients with end-stage hepatic alveolar echinococcosis (AE), and its surgical indications involve severe invasion of important hepatic vessels, which makes in vivo resection impossible. Revascularization is a major step in the process of ELRA, which is extremely challenging when the invaded vessels have huge defects.

CASE SUMMARY

Herein, we have reported the case of a 26-year-old patient with hepatic AE in an autologous liver graft who underwent complex inferior vena cava (IVC) reconstruction using disease-free IVC, autologous portal vein fragments, and umbilical vein within the ligamentum teres hepatis. The patient showed good surgical recovery without vascular-related complications during the long-term follow-up.

CONCLUSION

We reviewed three studies that have reported complex revascularization of the IVC. This case report and systematic review showed that the use of autologous perihepatic vessels prevents donor-area trauma, immune rejection, and other adverse reactions. When the blood vessel is severely invaded and a single vascular material cannot repair and reconstruct the defect, ELRA may provide a safe and feasible surgical approach, which has good prospects for clinical application.

Keywords: Hepatic alveolar echinococcosis; Ex vivo liver resection and autotransplantation; Inferior vena cava; Revascularization; Case report

Core Tip:Ex vivo liver resection and autotransplantation (ELRA) is an essential approach to cure end-stage hepatic alveolar echinococcosis (AE). Revascularization is a central and challenging step in the process of ELRA when the invaded vessels have large defects. Here, we report the case of a 26-year-old patient with hepatic AE in an autologous liver graft who underwent complex inferior vena cava (IVC) reconstruction using disease-free IVC, autologous portal vein fragments and umbilical vein within the ligamentum teres hepatis and with good surgical recovery without vascular-related complications at long-term follow-up. This study demonstrate that the blood vessel is severely invaded and a single vascular material cannot repair and reconstruct the defect, this technique may provide a feasible surgical option for revascularization during ELRA and has good prospects for clinical application.