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ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 40 Issue 12
Dec.  2024
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Article Contents

Current status of ex vivo liver resection and autotransplantation in treatment of benign liver lesions

DOI: 10.12449/JCH241228
Research funding:

The New Science and Technology Plan Project in Qinghai Province in 2022-Special Project for Innovation Platform Construction (1_8);

National Clinical Key Specialty Construction Project of Hepatobiliary Surgery (echinococcosis) of Qinghai University Affiliated Hospital (Qing Health and Wellness Office [2023] No.125)

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  • Corresponding author: HOU Lizhao, zhuoyue_1973@163.com (ORCID: 0000-0002-5697-554X)
  • Received Date: 2024-04-01
  • Accepted Date: 2024-04-26
  • Published Date: 2024-12-25
  • Benign liver lesions mainly include hepatic hemangioma, focal nodular hyperplasia of the liver, hepatocellular adenoma, and hepatic angiomyolipoma. Hepatic alveolar echinococcosis is a type of parasitic disease, and since it mainly occurs in the liver, it is also a benign lesion of the liver. The clinical treatment of benign liver lesions is mainly based on follow-up observation, supplemented by surgical resection. For patients with end-stage diseases, liver transplantation can be performed due to the large volume of the lesion, the invasion of a number of surrounding large vessels, unclear anatomic location, and the possibility of intraoperative rupture and massive hemorrhage. Since patients with poor liver function based on the liver allocation score for organ donation are more likely to get donor liver, it is difficult for patients with benign liver lesions to obtain the corresponding donor liver resources due to the growth pattern of benign liver lesions, thereby leading to the limited application of allogeneic liver transplantation. Since its emergence in the 1980s, ex vivo liver resection and autotransplantation (ELRA) has brought a new way for the treatment of such patients. This article summarizes the current application of ELRA in benign liver lesions, in order to provide a reference for diagnosis and treatment by clinical medical staff.

     

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  • [1]
    XU Y, LI J, LIU RJ, et al. Analysis of the use of immunosuppressants after liver transplantation in 95 hospitals in China during 2017-2021[J/CD]. Chin J Transplant(Electronic Edition), 2023, 17( 3): 134- 139. DOI: 10.3877/cma.j.issn.1674-3903.2023.03.002.

    徐烨, 李婧, 刘冉佳, 等. 2017至2021年中国95家医疗机构肝移植术后免疫抑制剂用药分析[J/CD]. 中华移植杂志(电子版), 2023, 17( 3): 134- 139. DOI: 10.3877/cma.j.issn.1674-3903.2023.03.002.
    [2]
    PICHLMAYR R, BRETSCHNEIDER HJ, KIRCHNER E, et al. Ex situ operation on the liver. A new possibility in liver surgery[J]. Langenbecks Arch Chir, 1988, 373( 2): 122- 126. DOI: 10.1007/BF01262775.
    [3]
    LU Q, AINI A, TANG R, et al. From liver surgery to liver transplant surgery: New developments in autotransplantation[J]. Curr Opin Organ Transplant, 2022, 27( 4): 337- 345. DOI: 10.1097/MOT.0000000000000999.
    [4]
    DENG X, YANG DCR, ZHANG LQ, et al. Current status of the surgical treatment of hepatic alveolar echinococcosis[J]. J Clin Hepatol, 2021, 37( 8): 1963- 1965. DOI: 10.3969/j.issn.1001-5256.2021.08.047.

    邓旭, 阳丹才让, 张灵强, 等. 泡型肝包虫病的外科治疗现状[J]. 临床肝胆病杂志, 2021, 37( 8): 1963- 1965. DOI: 10.3969/j.issn.1001-5256.2021.08.047.
    [5]
    KERN P, WEN H, SATO N, et al. WHO classification of alveolar echinococcosis: Principles and application[J]. Parasitol Int, 2006, 55 Suppl: S283- S287. DOI: 10.1016/j.parint.2005.11.041.
    [6]
    BUTTENSCHOEN K, GRUENER B, CARLI BUTTENSCHOEN D, et al. Palliative operation for the treatment of alveolar echinococcosis[J]. Langenbecks Arch Surg, 2009, 394( 1): 199- 204. DOI: 10.1007/s00423-008-0367-6.
    [7]
    YANG C, YANG HJ, DENG SP, et al. Current status of ex-vivo liver resection and autologous liver transplantation for end-stage hepatic alveolar echinococcosis[J]. Ann Palliat Med, 2020, 9( 4): 2271- 2278. DOI: 10.21037/apm-20-184.
    [8]
    WEN H, DONG JH, ZHANG JH, et al. Ex-vivo liver resection combined liver autotransplantation for the treatment of hepatic alveolar echinococcosis[J]. Chin J Dig Surg, 2011, 10( 2): 148- 149. DOI: 10.3760/cma.j.issn.1673-9752.2011.02.024.

    温浩, 董家鸿, 张金辉, 等. 体外肝切除联合自体肝移植治疗肝泡型包虫病[J]. 中华消化外科杂志, 2011, 10( 2): 148- 149. DOI: 10.3760/cma.j.issn.1673-9752.2011.02.024.
    [9]
    WANG H, LIU QY, WANG ZM, et al. Clinical outcomes of ex vivo liver resection and liver autotransplantation for hepatic alveolar echinococcosis[J]. J Huazhong Univ Sci Technolog Med Sci, 2012, 32( 4): 598- 600. DOI: 10.1007/s11596-012-1003-9.
    [10]
    YE QF, LI X, FAN XL, et al. Research on the indications of half in situ or ex situ liver resection and liver autotransplantation: A report 36 case[J]. Chin J Pract Surg, 2014, 34( 8): 749- 753. DOI: 10.7504/CJPS.ISSN1005-2208.2014.08.21.

    叶啟发, 李弦, 范晓礼, 等. 半离体或离体肝切除联合自体肝移植适应证探讨(附36例报告)[J]. 中国实用外科杂志, 2014, 34( 8): 749- 753. DOI: 10.7504/CJPS.ISSN1005-2208.2014.08.21.
    [11]
    WEN H, DONG JH, ZHANG JH, et al. Ex vivo liver resection and autotransplantation for end-stage alveolar echinococcosis: A case series[J]. Am J Transplant, 2016, 16( 2): 615- 624. DOI: 10.1111/ajt.13465.
    [12]
    YANG XW, QIU YW, HUANG B, et al. Novel techniques and preliminary results of ex vivo liver resection and autotransplantation for end-stage hepatic alveolar echinococcosis: A study of 31 cases[J]. Am J Transplant, 2018, 18( 7): 1668- 1679. DOI: 10.1111/ajt.14621.
    [13]
    AJI T, DONG JH, SHAO YM, et al. Ex vivo liver resection and autotransplantation as alternative to allotransplantation for end-stage hepatic alveolar echinococcosis[J]. J Hepatol, 2018, 69( 5): 1037- 1046. DOI: 10.1016/j.jhep.2018.07.006.
    [14]
    ZHANG Y, XIE P, YANG C, et al. Percutaneous stenting of left hepatic vein followed by ex vivo liver resection and autotransplantation in a patient with hepatic alveolar echinococcosis with Budd-Chiari syndrome[J]. Int J Surg Case Rep, 2020, 68: 251- 256. DOI: 10.1016/j.ijscr.2020.03.004.
    [15]
    AINI A, SHAO YM, SHALAYIADANG P, et al. Auxiliary partial autologous liver transplantation for high-selective alveolar echinococcosis: A proof of concept[J]. Transplantation, 2020, 104( 5): e138- e139. DOI: 10.1097/TP.0000000000003092.
    [16]
    SHU JJ, GONG Y, OU X, et al. Clinical efficacy of ex vivo liver resection and autotransplantation for liver complex space-occupying lesions[J]. Chin J Dig Surg, 2020, 19( 8): 869- 875. DOI: 10.3760/cma.j.cn115610-20200522-00377.

    舒俊傑, 弓毅, 欧霞, 等. 离体肝切除联合自体肝移植治疗肝脏复杂占位性病变的临床疗效[J]. 中华消化外科杂志, 2020, 19( 8): 869- 875. DOI: 10.3760/cma.j.cn115610-20200522-00377.
    [17]
    TIAN QS, FENG SP, GUO YM, et al. Postoperative complications of ex vivo liver resection combined with autologous liver transplantation in treatment of advanced hepatic alveolar echinococcosis at high altitude and related prevention and treatment strategies[J]. J Clin Hepatol, 2021, 37( 9): 2153- 2160. DOI: 10.3969/j.issn.1001-5256.2021.09.029.

    田青山, 冯少培, 郭亚民, 等. 高原地区体外肝切除联合自体肝移植术治疗晚期肝泡型包虫病的术后并发症及其防治策略[J]. 临床肝胆病杂志, 2021, 37( 9): 2153- 2160. DOI: 10.3969/j.issn.1001-5256.2021.09.029.
    [18]
    YUAN JQ, CHEN XB, HOU LZ, et al. Single-center experience of ex vivo liver resection and autotransplantation for complex hepatic alveolar echinoccosis[J]. Front Surg, 2023, 10: 1089788. DOI: 10.3389/fsurg.2023.1089788.
    [19]
    SHEN S, QIU YW, YANG XW, et al. Remnant liver-to-standard liver volume ratio below 40% is safe in ex vivo liver resection and autotransplantation[J]. J Gastrointest Surg, 2019, 23( 10): 1964- 1972. DOI: 10.1007/s11605-018-4022-4.
    [20]
    Chinese Doctor Association, Chinese College of Surgeons(CCS), Chinese Committee for Hadytidology(CCH). Expert consensus on diagnosis and treatment of hepatic cystic and alveolar echinococcosis(2019 edition)[J]. Chin J Dig Surg, 2019, 18( 8): 711- 721. DOI: 10.3760/cma.j.issn.1673-9752.2019.08.002.

    中国医师协会外科医师分会包虫病外科专业委员会. 肝两型包虫病诊断与治疗专家共识(2019版)[J]. 中华消化外科杂志, 2019, 18( 8): 711- 721. DOI: 10.3760/cma.j.issn.1673-9752.2019.08.002.
    [21]
    FAN YC, DENG MJ, YAN JX, et al. Clinical efficacy and safety of ex-vivo liver resection and liver auto-transplantation: A Bayesian single-arm Meta-analysis[J]. Chin J Hepatobiliary Surg, 2022, 28( 7): 547- 554. DOI: 10.3760/cma.j.cn113884-20220131-00051.

    樊羿辰, 邓满军, 鄢靖欣, 等. 离体肝切除联合自体肝移植的临床疗效及安全性评估的贝叶斯单臂荟萃分析[J]. 中华肝胆外科杂志, 2022, 28( 7): 547- 554. DOI: 10.3760/cma.j.cn113884-20220131-00051.
    [22]
    HUANG C, SUN HC. EASL clinical practice guidelines on the management of benign liver tumors(2016)[J]. J Clin Hepatol, 2016, 32( 8): 1439- 1445. DOI: 10.3969/j.issn.1001-5256.2016.08.001.

    黄成, 孙惠川. 2016年欧洲肝病学会临床实践指南:肝脏良性肿瘤的管理[J]. 临床肝胆病杂志, 2016, 32( 8): 1439- 1445. DOI: 10.3969/j.issn.1001-5256.2016.08.001.
    [23]
    OSTOJIC A, MRZLJAK A, MIKULIC D. Liver transplantation for benign liver tumors[J]. World J Hepatol, 2021, 13( 9): 1098- 1106. DOI: 10.4254/wjh.v13.i9.1098.
    [24]
    SUI CJ, YANG JM. Progress in diagnosis and treatment of hepatic hemangioma[J]. Chin J Pract Surg, 2009, 29( 11): 949- 952. DOI: 10.3321/j.issn:1005-2208.2009.11.026.

    隋承军, 杨甲梅. 肝血管瘤诊治进展[J]. 中国实用外科杂志, 2009, 29( 11): 949- 952. DOI: 10.3321/j.issn:1005-2208.2009.11.026.
    [25]
    OBANA A, SATO Y. Autologous partial liver transplantation for a symptomatic giant hepatic hemangioma. A case report[J]. Transplant Proc, 2022, 54( 10): 2787- 2790. DOI: 10.1016/j.transproceed.2022.09.025.
    [26]
    IKEGAMI T, SOEJIMA Y, TAKETOMI A, et al. Extracorporeal hepatic resection for unresectable giant hepatic hemangiomas[J]. Liver Transpl, 2008, 14( 1): 115- 117. DOI: 10.1002/lt.21272.
    [27]
    WANG J, JIN Y, MO YW. In vitro hepatectomy and autologous liver transplantation for giant hemangioma of liver: A case report[J]. China Pract Med, 2007, 2( 32): 204- 205. DOI: 10.3969/j.issn.1673-7555.2007.32.139.

    王军, 金焰, 莫一我. 离体肝切除自体肝移植治疗肝巨大血管瘤1例报告[J]. 中国实用医药, 2007, 2( 32): 204- 205. DOI: 10.3969/j.issn.1673-7555.2007.32.139.
    [28]
    DUAN XH, MAO XH, ZHOU LX, et al. Extracorporeal hepatectomy combined with autologous liver transplantation for giant hemangioma of liver: A case report[J]. China J Mod Med, 2018, 28( 14): 125- 128. DOI: 10.3969/j.issn.1005-8982.2018.014.027.

    段小辉, 毛先海, 周力学, 等. 离体肝切除联合自体肝移植治疗肝巨大血管瘤1例[J]. 中国现代医学杂志, 2018, 28( 14): 125- 128. DOI: 10.3969/j.issn.1005-8982.2018.014.027.
    [29]
    ZHANG KM, HU XW, DONG JH, et al. Ex-situ liver surgery without veno-venous bypass[J]. World J Gastroenterol, 2012, 18( 48): 7290- 7295. DOI: 10.3748/wjg.v18.i48.7290.
    [30]
    SUN JY, XIE K, TIAN XD, et al. Diagnosis and treatment of hepatic focal nodular hyperplasia[J]. Chin J Gen Surg, 2012, 27( 4): 292- 294. DOI: 10.3760/cma.j.issn.1007-631X.2012.04.010.

    孙建宇, 谢昆, 田孝东, 等. 肝脏局灶性结节性增生的诊断与治疗[J]. 中华普通外科杂志, 2012, 27( 4): 292- 294. DOI: 10.3760/cma.j.issn.1007-631X.2012.04.010.
    [31]
    OLDHAFER KJ, LANG H, SCHLITT HJ, et al. Long-term experience after ex situ liver surgery[J]. Surgery, 2000, 127( 5): 520- 527. DOI: 10.1067/msy.2000.105500.
    [32]
    ZHOU S, ZHANG SG, SONG RP, et al. The progress of hepatocellular adenoma malignant transforming in molecule mechanism researches[J]. Chin J Hepatobiliary Surg, 2019, 25( 10): 794- 796. DOI: 10.3760/cma.j.issn.1007-8118.2019.10.021.

    周烁, 张树庚, 宋瑞鹏, 等. 肝细胞腺瘤癌变分子机制的研究进展[J]. 中华肝胆外科杂志, 2019, 25( 10): 794- 796. DOI: 10.3760/cma.j.issn.1007-8118.2019.10.021.
    [33]
    STRAUSS E, FERREIRA ADES, FRANÇA AV, et al. Diagnosis and treatment of benign liver nodules: Brazilian Society of Hepatology(SBH) recommendations[J]. Arq Gastroenterol, 2015, 52( Suppl 1): 47- 54. DOI: 10.1590/S0004-28032015000500003.
    [34]
    MARRERO JA, AHN J, REDDY KR, et al. ACG clinical guideline: The diagnosis and management of focal liver lesions[J]. Am J Gastroenterol, 2014, 109( 9): 1328- 1347; quiz1348. DOI: 10.1038/ajg.2014.213.
    [35]
    European Association for the Study of the Liver(EASL). EASL Clinical Practice Guidelines on the management of benign liver tumours[J]. J Hepatol, 2016, 65( 2): 386- 98. DOI: 10.1016/j.jhep.2016.04.001.
    [36]
    TSUI WM, COLOMBARI R, PORTMANN BC, et al. Hepatic angiomyolipoma: A clinicopathologic study of 30 cases and delineation of unusual morphologic variants[J]. Am J Surg Pathol, 1999, 23( 1): 34- 48. DOI: 10.1097/00000478-199901000-00004.
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