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Case report: living donor liver transplantation for giant hepatic hemangioma using a right lobe graft without the middle hepatic vein.

Zhong L, Men TY, Yang GD, Gu Y, Chen G, Xing TH, Fan JW, Peng ZH - World J Surg Oncol (2014)

Bottom Line: We successfully operated using a right lobe graft without the middle hepatic vein from a 55-year-old donor.At the long-term follow-up, the patient experienced two acute rejections, which were confirmed by biopsy.However, the patient still survives with good graft function after 50 months.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of General Surgery, Shanghai First People Hospital, Medical School of Shanghai Jiaotong University, 85 Wu Jing Road, 200080 Shanghai, People's Republic of China. zhonglin1@medmail.com.cn.

ABSTRACT
Hepatic hemangioma patients with Kasabach-Merritt syndrome have reportedly been cured by liver transplantation. However, liver transplantation as a potential cure for a stable patient without Kasabach-Merritt syndrome remains debatable. We report the case of a 27-year-old female patient with a giant hepatic hemangioma. The hemangioma measured 50×40×25 cm in size and weighed 15 kg, which is the largest and heaviest hemangioma reported in the literature. The patient showed jaundice, ascites, anemia, and appetite loss; but no disseminated intravascular coagulation was observed through laboratory findings. We successfully operated using a right lobe graft without the middle hepatic vein from a 55-year-old donor. At the long-term follow-up, the patient experienced two acute rejections, which were confirmed by biopsy. However, the patient still survives with good graft function after 50 months.

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The giant hemangioma during surgery, approximately 50 × 40 × 25 cm in size.
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Figure 2: The giant hemangioma during surgery, approximately 50 × 40 × 25 cm in size.

Mentions: A 27-year-old female patient, who experienced upper abdominal pain and progressive hepatoma for 4 years, was diagnosed with a giant hepatic hemangioma. The patient showed mild jaundice, abdominal fullness, and abdominal varicose veins on presentation. Laboratory examination showed a hemoglobin level of 81 g/L and a platelet count of 95 × 109/L. Blood biochemistry showed total bilirubin concentration of 1.34 mg/dL, alanine aminotransferase concentration of 10 U/L, and creatinine level of 0.44 mg/dL. The coagulation tests showed a prothrombin time (PT) of 15.4 seconds, activated partial thromboplastin time of 35 seconds, fibrinogen concentration of 4.2 g/L, and fibrinogen degradation product tests were negative. An abdominal CT scan indicated the presence of low-density areas in both the liver lobes, occupying the entire abdominal cavity without rupture (Figure 1). The recipient was further examined and this revealed a hemangioma occupying the entire abdominal cavity, measuring approximately 50 × 40 × 25 cm in size (Figure 2).


Case report: living donor liver transplantation for giant hepatic hemangioma using a right lobe graft without the middle hepatic vein.

Zhong L, Men TY, Yang GD, Gu Y, Chen G, Xing TH, Fan JW, Peng ZH - World J Surg Oncol (2014)

The giant hemangioma during surgery, approximately 50 × 40 × 25 cm in size.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4016776&req=5

Figure 2: The giant hemangioma during surgery, approximately 50 × 40 × 25 cm in size.
Mentions: A 27-year-old female patient, who experienced upper abdominal pain and progressive hepatoma for 4 years, was diagnosed with a giant hepatic hemangioma. The patient showed mild jaundice, abdominal fullness, and abdominal varicose veins on presentation. Laboratory examination showed a hemoglobin level of 81 g/L and a platelet count of 95 × 109/L. Blood biochemistry showed total bilirubin concentration of 1.34 mg/dL, alanine aminotransferase concentration of 10 U/L, and creatinine level of 0.44 mg/dL. The coagulation tests showed a prothrombin time (PT) of 15.4 seconds, activated partial thromboplastin time of 35 seconds, fibrinogen concentration of 4.2 g/L, and fibrinogen degradation product tests were negative. An abdominal CT scan indicated the presence of low-density areas in both the liver lobes, occupying the entire abdominal cavity without rupture (Figure 1). The recipient was further examined and this revealed a hemangioma occupying the entire abdominal cavity, measuring approximately 50 × 40 × 25 cm in size (Figure 2).

Bottom Line: We successfully operated using a right lobe graft without the middle hepatic vein from a 55-year-old donor.At the long-term follow-up, the patient experienced two acute rejections, which were confirmed by biopsy.However, the patient still survives with good graft function after 50 months.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of General Surgery, Shanghai First People Hospital, Medical School of Shanghai Jiaotong University, 85 Wu Jing Road, 200080 Shanghai, People's Republic of China. zhonglin1@medmail.com.cn.

ABSTRACT
Hepatic hemangioma patients with Kasabach-Merritt syndrome have reportedly been cured by liver transplantation. However, liver transplantation as a potential cure for a stable patient without Kasabach-Merritt syndrome remains debatable. We report the case of a 27-year-old female patient with a giant hepatic hemangioma. The hemangioma measured 50×40×25 cm in size and weighed 15 kg, which is the largest and heaviest hemangioma reported in the literature. The patient showed jaundice, ascites, anemia, and appetite loss; but no disseminated intravascular coagulation was observed through laboratory findings. We successfully operated using a right lobe graft without the middle hepatic vein from a 55-year-old donor. At the long-term follow-up, the patient experienced two acute rejections, which were confirmed by biopsy. However, the patient still survives with good graft function after 50 months.

Show MeSH
Related in: MedlinePlus