
pmid: 19073403
handle: 2158/1168675
Liver resection after liver transplantation is a relatively uncommon procedure. Indications for liver resection include hepatic artery thrombosis (HAT), non-anastomotic biliary stricture (ischemic biliary lesions), liver abscess, liver trauma and recurrence of hepatocellular carcinoma (HCC). Organ shortage and lower survival after re-transplantation have encouraged us to make attempts at graft salvage.Eleven resections at a mean of 59 months after liver transplantation were made over 18 years. Indications for liver resection included HCC recurrence in 4 patients, ischemic cholangiopathy, segmental HAT, sepsis and infected hematoma in 2 each, and ischemic segment IV after split liver transplantation in 1.There was no perioperative mortality. Morbidity included one re-laparotomy for small bowel perforation, one bile leak treated conservatively, one right subphrenic collection, one wound infection and 5 episodes of Gram-negative sepsis. One patient underwent re-transplantation 4 months after resection for chronic rejection. There were 3 deaths, two from HCC recurrence and one from post-transplant lymphoproliferative disorder. The overall mean follow-up after resection was 48 months.Liver resection in liver transplant recipients is safe, and has good outcome in selected patients and avoids re-transplantation in the majority of patients. Recipients with recurrent HCC in graft may benefit from resection, but cure is uncommon.
Reoperation, Carcinoma, Hepatocellular, Cholestasis, Liver Neoplasms, Thrombosis, Middle Aged, Liver Transplantation, Postoperative Complications, Child, Preschool, Hepatectomy, Humans, Hospital Mortality, Neoplasm Recurrence, Local, Child, Follow-Up Studies
Reoperation, Carcinoma, Hepatocellular, Cholestasis, Liver Neoplasms, Thrombosis, Middle Aged, Liver Transplantation, Postoperative Complications, Child, Preschool, Hepatectomy, Humans, Hospital Mortality, Neoplasm Recurrence, Local, Child, Follow-Up Studies
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