Retrohepatic vena cava deroofing in living donor liver transplantation for caudate hepatocellular carcinoma.

Abstract

The removal of tumor together with the native liver in living donor liver transplantation for hepatocellular carcinoma is challenged by a very close resection margin if the tumor abuts the inferior vena cava. This is in contrast to typical deceased donor liver transplantation where the entire retrohepatic inferior vena cava is included in total hepatectomy. Here we report a case of deroofing the retrohepatic vena cava in living donor liver transplantation for caudate hepatocellular carcinoma. In order to ensure clear resection margins, the anterior portion of the inferior vena cava was included. The right liver graft was inset into a Dacron vascular graft on the back table and the composite graft was then implanted to the recipient inferior vena cava. Using this technique, we observed the no-touch technique in tumor removal, hence minimizing the chance of positive resection margin as well as the chance of shedding of tumor cells during manipulation in operation.

• Authors: See Ching Chan, William W Sharr, Tan To Cheung, Albert C Y Chan, Simon H Y Tsang, Kenneth S H Chok, Kin Chung Leung, Chung Mau Lo
• Journal: Hepatobiliary & pancreatic diseases international : HBPD INT (Hepatobiliary Pancreat Dis Int) Vol. 12 Issue 5 Pg. 552-5 (Oct 2013) ISSN: 1499-3872 [Print] Singapore
• PMID: 24103288 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Polyethylene Terephthalates

Topics

• Biopsy
• Blood Vessel Prosthesis
• Blood Vessel Prosthesis Implantation (instrumentation)
• Carcinoma, Hepatocellular (pathology, surgery)
• Humans
• Liver Neoplasms (pathology, surgery)
• Liver Transplantation (adverse effects, instrumentation, methods)
• Living Donors
• Male
• Middle Aged
• Neoplasm Seeding
• Neoplasm, Residual
• Phlebography (methods)
• Polyethylene Terephthalates
• Prosthesis Design
• Tomography, X-Ray Computed
• Treatment Outcome
• Vena Cava, Inferior (diagnostic imaging, surgery)