Transplantation techniques for liver resections in children

Abstract

   Aim. To carry out a retrospective analysis of the treatment outcomes of the patients who underwent liver resection with angioplasty facilitated by transplantation techniques.   Materials and methods. The sample of cases was divided into four groups: liver resection with total vascular isolation of the liver, ante situm liver resection, hepatic artery and portal vein reconstruction, cardiopulmonary bypass resection. The analysis was focused on surgery features and treatment outcomes.   Results. The study involved 29 patients. The performed interventions included 11 liver resections with total vascular isolation, 6 ante situm liver resections, 7 resections with angioplasty, and 5 cardiopulmonary bypass resections. 5 patients (17 %) developed complications that required reoperation. Within 90 days, 4 patients (14 %) died. For patients with malignant neoplasms, one-, three-, and five-year overall survival rates accounted for 84.4 %, 58.4 %, and 51.1 %; one-year event-free survival rate comprised 57.1 %, and three- and five-year event-free survival was 41.7 %.The study revealed no significant differences in the complication rates. The groups of ante situm liver resections and cardiopulmonary bypass resections significantly differed from the other groups by the higher incidence of tumor progression, invasion of adjacent organs, hemorrhagic complications, preoperative stay, and duration of cold perfusion of the liver. The cardiopulmonary bypass resections were noted to have higher duration of surgery, vascular isolation, heparin use, and the frequency of anticoagulant therapy before surgery.   Conclusion. Liver resections with total vascular isolation, angioplasty and transplantation techniques are considered as the only possible treatment option for a number of patients. Further accumulation of results will reduce the risk of adverse outcomes.