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首页> 外文期刊>Pediatric transplantation. >Use of a donor iliac vein graft for reconstruction of the inferior vena cava in liver transplantation for hepatoblastoma with caval extension
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Use of a donor iliac vein graft for reconstruction of the inferior vena cava in liver transplantation for hepatoblastoma with caval extension

机译：用胃癌肝脏移植术治疗肝脏移植术治疗肝脏移植瘤的肝脏移植瘤

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Abstract Complete microscopic tumor resection is critical for successful treatment of hepatoblastoma, and this may include when liver transplantation is required. For tumors involving the IVC or PV, complete resection should include the involved IVC or PV to ensure full tumor clearance. When this is required, the venous reconstruction at transplant or post‐excision can be challenging. We present the management of an 18‐month‐old girl with PRETEXT Stage IV (P, V, F) hepatoblastoma and IVC involvement, where native caval resection and reconstruction was required. The preoperative staging following neoadjuvant chemotherapy was POSTTEXT Stage IV (P, V, F). An orthotopic liver transplantation was performed using a left lateral segment graft from a deceased adult donor. With native hepatectomy, retrohepatic IVC resection from just above the hepatic venous confluence to just above the entry of the right adrenal vein was performed. For caval reconstruction, a venous graft from a deceased donor was used. The graft included the lower IVC with the right common iliac vein and a short stump of the left common iliac vein. The common iliac was a perfect size match for the IVC, and the three natural ostia matched the upper cava, lower cava, and the outflow from the donor left hepatic vein. The patient had an uneventful postoperative course and remains well and disease‐free 2?years after transplant with continued patency of the reconstructed cava. When indicated, a donor iliac vein graft with its natural ostia should be considered in caval reconstruction for pediatric liver transplantation.
机译：摘要完全显微肿瘤切除对于成功治疗肝母细胞瘤至关重要，这可能包括肝移植时。对于涉及IVC或PV的肿瘤，完全切除应包括所涉及的IVC或PV，以确保全肿瘤清除。当需要这种情况时，移植或切除后的静脉重建可能是具有挑战性的。我们展示了一个18个月大女孩的借口阶段IV（P，V，F）肝气肿和IVC参与，其中需要本地穴位切除和重建。 Neoadjuvant化疗后的术前分期是后术阶段IV（P，V，F）。使用来自已故的成人供体的左侧侧段接枝进行原位肝移植。用天然肝切除术，刚刚高于肝静脉汇合的Retrohepatic IVC切除术在右上肾上腺静脉进入。对于穴形重建，使用来自已故供体的静脉移植物。移植物包括较低的IVC，具有良好的髂静脉和左常见髂静脉的短树桩。常见的髂髂髂型是IVC的完美尺寸匹配，三个天然骨骼匹配上静脉，下静脉，来自供体左肝静脉的流出。患者的术后疗程有一个平坦的术后疗程，并且在移植后仍然良好，无病2年，重建的CATCA继续平坦。当指出时，应考虑在儿科肝移植的穴居重建中考虑与其天然卵体的供体髂静脉移植物。

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