Ex Vivo Liver Resection and Autotransplantation for End-Stage Alveolar Echinococcosis: A Case Series.

Introduction: The use of various types of invasive interventions combined with anti-infective drugs in the therapeutic strategy of alveolar echinococcosis (AE) has changed during the last 30 years.Areas covered: This article reviews the current respective indications of surgical, percutaneous and perendoscopic interventions in AE and proposes an integrative therapeutic strategy.Expert commentary: Hepatic resection is indicated whenever it is feasible and curative; palliative surgery should be avoided; percutaneous procedures are best adapted to the drainage of the necrotic cavity present in advanced cases; perendoscopic procedures with stenting are best adapted to alleviating the biliary complications that are common and life-threatening in AE patients. Continuous administration of albendazole or mebendazole, without interruption is mandatory in all cases, temporarily (recommended duration: 2 years) after radical lesion resection in patients without immune suppression; for life in all other cases....

Current interventional strategy for the treatment of hepatic alveolar echinococcosis

https://onlinelibrary.wiley.com/doi/pdf/10.1111/ajt.14621

Novel techniques and preliminary results of ex vivo liver resection and autotransplantation for end-stage hepatic alveolar echinococcosis: A study of 31 cases.

Ex vivo liver resection followed by autotransplantation to a patient with advanced alveolar echinococcosis with a replacement of the retrohepatic inferior vena cava using autogenous vein grafting: a case report and literature review.

The choose of different surgical therapies of hepatic alveolar echinococcosis: A single-center retrospective case-control study.

The effectiveness of liver autotransplantation for patients with partial hepatic alveolar echinococcosis was analyzed. We retrospectively studied 6 patients with hepatic alveolar echinococcosis who underwent liver autotransplantation in our hospital from 2008 to 2010. We also summarized the surgical indications of liver autotransplantation for hepatic alveolar echinococcosis and our experience in the management of postoperative complications of liver autotransplantation. Of 6 patients, 5 achieved good curative results, and one died of multiple organ failure caused by portal vein thrombosis. Main complications included postoperative bleeding, bile leak and small-for-size liver graft syndrome. Liver autotransplantation offers a new approach to cure hepatic alveolar echinococcosis with non-resectable lesions. It could be the most effective method to cure intractable hepatic alveolar echinococcosis if correct handling in operation and proper prevention of complications are performed. But the long-term outcomes are still needed to be confirmed in longer follow-up.

Zhaoming Wang

Papers

Clinical outcomes of Ex Vivo liver resection and liver autotransplantation for hepatic alveolar echinococcosis

Medical simulation-based education improves medicos' clinical skills.