Liver transplantation with vena cava replacement for advanced alveolar echinococcosis: a case report
| Author |
|---|
Magilevičiūtė, Roberta |
| Date | Start Page | End Page |
|---|---|---|
2025-04-25 | 271 | 272 |
Abstract No. 172
Prieskyros nenurodytos
Alveolar echinococcosis, caused by Echinococcus multilocularis, is a highly aggressive form of echinococcosis that behaves like a slowly growing malignant tumor. Radical surgical resection combined with antihelminthic therapy is the first-line treatment for this disease. However, due to the parasite's insidious growth, delayed diagnosis and involvement of major vessels, some cases become unresectable. In these cases, a
multidisciplinary approach is essential and liver transplantation remains the only life- saving option.Case report:A 31-year-old man presented with symptoms of dark urine,
fatigue, and generalized weakness. An abdominal CT scan revealed hepatomegaly with a 12 × 10 cm mass in the right lobe and infiltration into the inferior vena cava. Based on these findings and additional tests, the patient was diagnosed with alveolar echinococcosis. Due to the advanced stage of the disease and vascular involvement, the lesion was unresectable. After careful evaluation, a multidisciplinary team decided that liver transplantation was the only possible treatment option. Once a suitable organ donor was found, the patient underwent liver transplantation. The exact extent of the inferior vena cava infiltration was only fully identified during the surgery. The surgical procedure was highly complex, requiring not only the removal of the parasite affected liver but also the resection of infiltrated portion of the inferior vena cava and part of the diaphragm. The surgical team performed an end-to-end anastomosis between the recipient’s and the donor’s inferior vena cava, followed by the implantation of the donor liver. The patient was treated with albendazole both before and after the surgery. The procedure was successfully completed without complications, and the patient’s postoperative recovery was smooth.Conclusion:This case represents the first liver transplantation for alveolar echinococcosis in the country, highlighting the importance of multidisciplinary collaboration and advanced surgical techniques in the management of complex hepatic parasitic diseases.