Liver transplantation for patients with hepatic alveolar echinococcosis in late stage

Failed surgical treatment and multiple operations often lead to liver failure and make it difficult to be treated by traditional methods. Liver transplantation may be the ideal and the last choice. In this study we tried to explore the indication of liver transplantation for hepatic alveolar echinococcosis (HAE) and the improvement of intraoperative treatment.

Five patients who had received liver transplantation of hepatic alveolar echinococcosis in our hospital from 1999 through 2003 were analyzed retrospectively.

All the patients (3 were male and 2 female) were in late stage of hepatic alveolar echinococcosis. During orthotopic liver transplantation(OLT), 4 patients underwent veno-venous bypass, 3 were subjected to veno-venous bypass prior to the mobilization of the liver, and 2 received placement of T tube in the bile duct. In all the patients treated successfully by OLT, 4 recovered, and 1 died of severe infection and acute rejection after operation. T tube fell off in one patient. Postoperatively, pathological diagnosis verified hepatic alveolar echinococcosis. Four patients were followed up to the present, showing a good life quality and work capacity.

Hepatic alveolar echinococcosis in late stage can be considered as one of the indications of liver transplantation. Technique of veno-venous bypass prior to the mobilization of the liver could decrease operative time and bleeding. Early diagnosis and treatment of the disease ensures a better prognosis.