Liver transplantation for the treatment of end-stage hepatic alveolar echinococcosis
JI Xue-wen, ZHANG Jin-hui, ZHAO Jin-ming, TAI Qin-wen, SHAO Ying-mei, LI li, LI Tao, WEN Hao
Published 2011-08-20
Cite as Chin J Dig Surg, 2011,10(04): 299-301. DOI: 10.3760/cma.j.issn.1673-9752.2011.04.017
Abstract
Objectiye To investigate the value of liver transplantation for the treatment of end-stage hepatic alveolar echinococcosis(HAE).Methods The clinical data of 8 patients with end-stage HAE who received liver transplantation at the First Affiliated Hospital of Xinjiang Medical University from December 2000 to August 2010 were retrospectively analyzed.The operation time,anhepatic phase,infusion of suspension of red blood cells and postoperative complications were observed.Results The median operation time,anhepatic phase and infusion of suspension of red blood cells were 635 minutes(range,490-760 minutes),66 minutes(range,44-240 minutes)and 20 U(range,4-40 U).Liver transplantation was successfully carried out on 7 patients except for 1 patient who received emergent liver transplantation died of severe hepatic encephalopathy,renal failure and coagulation disorder on postoperative day 1.The median follow-up time was 6 months(range,3-29 months).One patient died of septicopyemia in postoperative month 3,1 died of incurable infection of bile duct in postoperative month 5,and 1 died of acute rejection in postoperative month 6.One patient was complicated with stricture of the bile duct anastomosis,and was cured by choledochojejunostomy.The size of the metastatic lesion in the left lung of 1 patient was reduced.One patient who underwent liver autotransplantation had no signs of residual liver disease with good liver function.Conclusion End-stage HAE is an indication for liver transplantation.A minimum dose of immunosuppressive agent and systemic administration of anti-HAE drugs are necessary to prevent the recurrence of HAE and ensure a long-term survival.Liver autotransplantation is the optimal method for the treatment of end-stage HAE,because no immunosuppressive agent is needed after operation.
Key words:
Hepatic alveolar echinococcosis; Liver transplantation,orthotopic; Liver transplantation,autologous
Contributor Information
JI Xue-wen
Department of Liver and Laparoscopy Surgery,First Affiliated Hospital,Xinjiang Medical University,Urumqi 830054,China
ZHANG Jin-hui
Department of Liver and Laparoscopy Surgery,First Affiliated Hospital,Xinjiang Medical University,Urumqi 830054,China
ZHAO Jin-ming
Department of Liver and Laparoscopy Surgery,First Affiliated Hospital,Xinjiang Medical University,Urumqi 830054,China
TAI Qin-wen
Department of Liver and Laparoscopy Surgery,First Affiliated Hospital,Xinjiang Medical University,Urumqi 830054,China
SHAO Ying-mei
Department of Liver and Laparoscopy Surgery,First Affiliated Hospital,Xinjiang Medical University,Urumqi 830054,China
LI li
Department of Liver and Laparoscopy Surgery,First Affiliated Hospital,Xinjiang Medical University,Urumqi 830054,China
LI Tao
Department of Liver and Laparoscopy Surgery,First Affiliated Hospital,Xinjiang Medical University,Urumqi 830054,China
WEN Hao
Department of Liver and Laparoscopy Surgery,First Affiliated Hospital,Xinjiang Medical University,Urumqi 830054,China