Akademik Veri Yönetim Sistemi
25 th EUPSA CONGRESS, Bologna, İtalya, 12 - 15 Haziran 2024, ss.279-280
Aim of the study Complete resection is crucial for the cure of hepatoblastoma. Total hepatectomy and liver transplantation is the only option for unresectable hepatoblastoma . In LDLT for advanced hepatoblastoma with retrohepatic IVC invasion, reconstruction of the recipient IVC is necessary. Herein, we present a case of pediatric LDLT with IVC homograft replacement for advanced hepatoblastoma. Case description: The patient was a 20-kg, 4-year-old boy suffering from multifocal hepatoblastoma with invasion of retrohepatic IVC, unresponsive to neoadjuvant chemotherapy. The α-feto-protein level of the patient was 365.000. The patient underwent LDLT with left liver lobe(LL) procured from his uncle. TH with retrohepatic IVC excision was performed. A 7 cm-long and two cm-wide, cold stored, fresh(5 days old ) IVC homograft was anastomosed to supra-hepatic IVC and infra-hepatic IVC after total clamping of suprahepatic and infrahepatic IVC. While waiting to procure the LL graft from the donor, a transient portocaval shunt was done. 382g LL graft was implanted, HV anastomosis was done by creating a wide three-dimensional opening on the IVC graft.Portal vein and hepatic artery anastomoses were done in standard fashion. A duct-to-duct anastomosis was done to reconstruct the bile duct.The patient was discharged three weeks after LDLT, and his α-feto-protein level decreased to normal in six weeks. The patient is doing well during six months of follow-up. Conclusion: TH with retrohepatic IVC resection and replacement is a feasible option for pediatric LDLT for advanced hepatoblastoma. LDLT eliminates the risks of tumor relapse during prolonged waiting times for cadaveric liver grafts.