Detailed Abstract
[E-poster]
[EP044] Use of iliac vein allograft in living donor liver transplantation for pediatric patients with advanced hepatoblastoma and pancreatoblastoma
Shin HWANG*, Jung-Man NAMGOONG, Chul-Soo AHN, Gi-Won SONG, Dong-Hwan JUNG, Gil-Chun PARK
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Korea
Introduction : Iliac vein allograft (IVA) has been used for living donor liver transplantation (LDLT).
Methods : We herein introduce two cases of IVA use in LDLT in pediatric patients with advanced hepatoblastoma and pancreatoblastoma.
Results : The first case was IVC replacement with IVA for advanced hepatoblastoma. The patient was an 18 month-old girl suffering from large multiple hepatoblastomas. The tumors encroached the retrohepatic IVC, thus the IVC had to be removed. A 4 cm-long common IVA was attached to the mother’s left lateral section liver. This liver graft was implanted as like standard deceased donor liver transplantation. The second case was PV interposition with IVA for advanced pancreatoblastoma. The patient was a 4-year-old boy suffering from large multiple pancreatoblastoma. The tumors encroached the superior mesenteric vein (SMV) and PV, thus these vascular structures had to be removed. He underwent spleen-preserving total pancreatectomy under temporary portal bypass between the SMV and IVC. The left liver graft was implanted and the graft PV was anastomosed with the interposed IVA graft attached at the SMV stump. These two patients recovered uneventfully and are undergoing scheduled adjuvant chemotherapy to date.
Conclusions : If IVA is not available, LDLT for these pediatric patients was not attempted because complete removal of the primary tumor was not possible. Use of IVA has expanded the indications of pediatric LDLT where prosthetic vascular grafts cannot be used. For pediatric recipients, various vein allografts can be used depending on body size of the recipient and availability of vessel grafts.
Methods : We herein introduce two cases of IVA use in LDLT in pediatric patients with advanced hepatoblastoma and pancreatoblastoma.
Results : The first case was IVC replacement with IVA for advanced hepatoblastoma. The patient was an 18 month-old girl suffering from large multiple hepatoblastomas. The tumors encroached the retrohepatic IVC, thus the IVC had to be removed. A 4 cm-long common IVA was attached to the mother’s left lateral section liver. This liver graft was implanted as like standard deceased donor liver transplantation. The second case was PV interposition with IVA for advanced pancreatoblastoma. The patient was a 4-year-old boy suffering from large multiple pancreatoblastoma. The tumors encroached the superior mesenteric vein (SMV) and PV, thus these vascular structures had to be removed. He underwent spleen-preserving total pancreatectomy under temporary portal bypass between the SMV and IVC. The left liver graft was implanted and the graft PV was anastomosed with the interposed IVA graft attached at the SMV stump. These two patients recovered uneventfully and are undergoing scheduled adjuvant chemotherapy to date.
Conclusions : If IVA is not available, LDLT for these pediatric patients was not attempted because complete removal of the primary tumor was not possible. Use of IVA has expanded the indications of pediatric LDLT where prosthetic vascular grafts cannot be used. For pediatric recipients, various vein allografts can be used depending on body size of the recipient and availability of vessel grafts.
SESSION
E-poster
E-Session 7/27 ~ 7/29 ALL DAY