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Retrohepatic vena cava deroofing in living donor liver transplantation for caudate hepatocellular carcinoma |
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| Authors: | See Ching Chan William W Sharr Tan To Cheung Albert CY Chan Simon HY Tsang Kenneth SH Chok Kin Chung Leung Chung Mau Lo |
| Institution: | 1. Department of Surgery, The University of Hong Kong, 102 Pokfulam Road, Hong Kong, China;2. State Key Laboratory for Liver Research, The University of Hong Kong, 102 Pokfulam Road, Hong Kong, China;3. Department of Pathology, The University of Hong Kong, 102 Pokfulam Road, Hong Kong, China;1. Department of Endoscopy and Motility Unit, G. Gennimatas General Hospital, Thessaloniki, Greece;2. 2nd Department of Internal Medicine, School of Medicine, Aristotle University of Thessaloniki, Ippokration Hospital, Thessaloniki, Greece;1. Sichuan Provincial Pancreatitis Center, Department of Integrated Traditional Chinese and Western Medicine, Chengdu, China;2. Department of Hepato-Biliary-Pancreatic Surgery, Chengdu, China;3. West China Hospital, Sichuan University, Chengdu 610041, China;4. NIHR Liverpool Pancreas Biomedical Research Unit, Royal Liverpool University Hospital, University of Liverpool, Liverpool L69 3BX, UK;1. Department of Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China;2. Department of Ultrasound, First Affiliated Hospital of Nanchang University, Nanchang 330006, China |
| Abstract: | The removal of tumor together with the native liver in living donor liver transplantation for hepatocellular carcinoma is challenged by a very close resection margin if the tumor abuts the inferior vena cava. This is in contrast to typical deceased donor liver transplantation where the entire retrohepatic inferior vena cava is included in total hepatectomy. Here we report a case of deroofing the retrohepatic vena cava in living donor liver transplantation for caudate hepatocellular carcinoma. In order to ensure clear resection margins, the anterior portion of the inferior vena cava was included. The right liver graft was inset into a Dacron vascular graft on the back table and the composite graft was then implanted to the recipient inferior vena cava. Using this technique, we observed the no-touch technique in tumor removal, hence minimizing the chance of positive resection margin as well as the chance of shedding of tumor cells during manipulation in operation. |
| Keywords: | hepatocellular carcinoma liver transplantation |
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