Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 26, 2022; 10(12): 3834-3841
Published online Apr 26, 2022. doi: 10.12998/wjcc.v10.i12.3834
Pediatric living donor liver transplantation using liver allograft after ex vivo backtable resection of hemangioma: A case report
Shu-Xuan Li, He-Nan Tang, Guo-Yue Lv, Xuan Chen
Shu-Xuan Li, He-Nan Tang, Guo-Yue Lv, Department of Hepatobiliary and Pancreatic Surgery, the First Hospital of Jilin University, Changchun 130021, Jilin Province, China
Xuan Chen, Department of Neurosurgery, the First Hospital of Jilin University, Changchun 130021, Jilin Province, China
Author contributions: Li SX and Tang HN contributed equally to this work; Li SX wrote the original draft of the manuscript; Tang HN performed the analyses and interpretation of the imaging findings; Lv GY was responsible for the methodology and data curation; Chen X was responsible for the revision and editing of the manuscript; all authors issued final approval for the version to be submitted.
Informed consent statement: Patients provided informed written consent.
Conflict-of-interest statement: The authors have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xuan Chen, PhD, Professor, Department of Neurosurgery, the First Hospital of Jilin University, No. 1 Xinmin Street, Changchun130021, Jilin Province, China. chen_xuan@jlu.edu.cn
Received: July 23, 2021
Peer-review started: July 23, 2021
First decision: October 15, 2021
Revised: October 25, 2021
Accepted: March 4, 2022
Article in press: March 4, 2022
Published online: April 26, 2022
Abstract
BACKGROUND

Use of liver allograft with hepatic hemangioma after in vivo resection of hemangioma in living donor liver transplantation (LDLT) has been previously reported. However, there are few reports describing ex vivo backtable resection of hemangioma from liver allografts in LDLT.

CASE SUMMARY

A 55-year-old male was evaluated as a donor for an 8-month-year old patient with acute hepatic failure due to biliary atresia. Pre-operative contrast enhanced computed tomography revealed a 9 cm hemangioma in segment 4 with vascular variations in the donor. During LDLT, an intra-operative intrahepatic cholangiography was performed to ensure no variation in the anatomy of the intrahepatic bile duct. After intra-operative pathological diagnosis, ex vivo backtable resection of the hemangioma was performed and the liver allograft was transplanted into the recipient. The donor’s and recipient’s post-operative course were uneventful. At the 2-year follow-up, the liver allograft showed good regeneration without any recurrence of hemangioma.

CONCLUSION

Liver allografts with hemangiomas are an acceptable alternative strategy for LDLT. Ex vivo backtable resection of hemangioma from the donor liver during pediatric LDLT is safe and feasible, and can effectively reduce the operative time and intra-operative bleeding for the donor.

Keywords: Hemangioma, Liver allograft, ex vivo resection, Backtable resection, Pediatric living donor liver transplantation, Case report

Core Tip: It is of great significance to expand the liver donor pool due to the shortage of donor livers. In this paper, we describe how a discard left lobe of the liver with hemangioma after hepatectomy was fixed backtable to meet the criteria for transplantation. Subsequently, a successful liver transplantation was performed for a 2-year-old child with congenital biliary atresia by using this liver with satisfactory outcome. Two years of follow-up showed that the child recovered well with no significant complications.