Ann Liver Transplant.  2025 May;5(1):54-60. 10.52604/alt.24.0024.

Retrohepatic inferior vena cava interposition in living donor liver transplantation for a pediatric patient with advanced hepatoblastoma

• Namgoong JM
• Hwang S
• Park GC
• Kwon H
• Ha S
• Gang S
• Park J
• Kim KM
• Oh SH

• KMID: 2568376
• DOI: http://doi.org/10.52604/alt.24.0024

Abstract

Replacement of the retrohepatic inferior vena cava (IVC) after concurrent resection of IVC and tumor-bearing liver is regarded as a feasible living donor liver transplantation (LDLT) technique to cope with tumors around the IVC. This method can make the resection extent of LDLT comparable to that of deceased-donor liver transplantation. We present one pediatric LDLT case with IVC replacement using an enlarged iliac vein conduit to treat advanced hepatoblastoma. The patient was a 33-monthold and 12 kg-weighing girl suffering from large multiple hepatoblastomas invading the retrohepatic IVC. At 2-month waiting after deciding LDLT, we obtained a coldstored iliac vein graft and LDLT was performed with the father’s left lateral section graft. A 1.3 cm-wide and 10 cm-long iliac vein was transformed to be a 2 cm-wide and 5 cm-long vein graft through a double-barrel unification venoplasty. The left lateral section graft was implanted along the standard procedure of LDLT. The patient recovered uneventfully and is undergoing scheduled adjuvant chemotherapy. IVC replacement with vein homograft is a feasible option for LDLT in pediatric patients with advanced liver malignancy.

Keyword

Interposition; Venoplasty; Pediatric transplantation; Neoadjuvant chemotherapy; Vein allograft