Ex vivo hepatic resection and autotransplantation with cardiopulmonary bypass for hepatoblastoma in children: one case report

Abstract

Objective To explore the application of ex vivo hepatic resection and autotransplantation for complicated hepatoblastoma in children. Methods One patient with hepatoblastoma after repeated chemotherapy was analyzed. Tumor invasion included Ⅳ, Ⅴ, Ⅷ segments of liver and thrombosis in inferior vena cava and right atrium.Conventional hepatectomy proved difficult for tumor resection. This patient underwent ex vivo hepatic resection and autotransplantation, removal of tumor thrombus in inferior vena cava and right atrium with cardiopulmonary bypass. Operative approaches and precautions during and after operation were examined. Results The operation was completed successfully within 8 h and liver cold ischemia time was 190 min. Recovery was smooth. Liver function and level of AFP gradually returned to normal at 2 weeks postoperatively. Ultrasonic examination showed that blood flow velocity of hepatic vein, portal vein and hepatic artery was excellent. Discharge occurred at 3 weeks postoperatively. Conclusions Ex vivo hepatic resection and autotransplantation is efficacious for complicated hepatoblastoma in children. Key words: Liver neoplasms; Liver transplantation; Hepatectomy