NDLI: Liver autotransplantation and atrial reconstruction on a patient with multiorgan alveolar echinococcosis: a case report

Content Provider	Springer Nature : BioMed Central
Author	Ruze, Rexiati Jiang, Tiemin Zhang, Weimin Zhang, Mingming Zhang, Ruiqing Guo, Qiang Aboduhelili, Aboduhaiwaier Zhayier, Musitapa Mahmood, Ahmad Yu, Zhaoxia Ye, Jianrong Shao, Yingmei Aji, Tuerganaili
Abstract	Background Alveolar echinococcosis (AE) primarily affects the liver and potentially spreads to other organs. Managing recurrent AE poses significant challenges, especially when it involves critical structures and multiple major organs. Case presentation We present a case of a 59-year-old female with recurrent AE affecting the liver, heart, and lungs following two previous hepatectomies, the hepatic lesions persisted, adhering to major veins, and imaging revealed additional diaphragmatic, cardiac, and pulmonary involvement. The ex vivo liver resection and autotransplantation (ELRA), first in human combined with right atrium (RA) reconstruction were performed utilizing cardiopulmonary bypass, and repairs of the pericardium and diaphragm. This approach aimed to offer a potentially curative solution for lesions previously considered inoperable without requiring a donor organ or immunosuppressants. The patient encountered multiple serious complications, including atrial fibrillation, deteriorated liver function, severe pulmonary infection, respiratory failure, and acute kidney injury (AKI). These complications necessitated intensive intraoperative and postoperative care, emphasizing the need for a comprehensive management strategy in such complicated high-risk surgeries. Conclusions The multidisciplinary collaboration in this case proved effective and yielded significant therapeutic outcomes for a rare case of advanced hepatic, cardiac, and pulmonary AE. The combined approach of ELRA and RA reconstruction under extracorporeal circulation demonstrated distinct advantages of ELRA in treating complex HAE. Meanwhile, assessing diaphragm function during the perioperative period, especially in patients at high risk of developing pulmonary complications and undergoing diaphragmectomy is vital to promote optimal postoperative recovery. For multi-resistant infection, it is imperative to take all possible measures to mitigate the risk of AKI if vancomycin administration is deemed necessary.
Related Links	https://bmcinfectdis.biomedcentral.com/counter/pdf/10.1186/s12879-024-09545-0.pdf
Ending Page	10
Page Count	10
Starting Page	1
File Format	HTM / HTML
ISSN	14712334
DOI	10.1186/s12879-024-09545-0
Journal	BMC Infectious Diseases
Issue Number	1
Volume Number	24
Language	English
Publisher	BioMed Central
Publisher Date	2024-07-02
Access Restriction	Open
Subject Keyword	Infectious Diseases Parasitology Medical Microbiology Tropical Medicine Internal Medicine Hepatic alveolar echinococcosis Cardiac alveolar echinococcosis Liver autotransplantation Atrial reconstruction Case report
Content Type	Text
Resource Type	Case study
Subject	Infectious Diseases
Journal Impact Factor	3.4/2023
5-Year Journal Impact Factor	3.3/2023

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Correction: Liver autotransplantation and atrial reconstruction on a patient with multiorgan alveolar echinococcosis: a case report

Kidney invasion occurred 2 years following liver transplantation for hepatic alveolar echinococcosis: a case report

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Correction: Liver autotransplantation and atrial reconstruction on a patient with multiorgan alveolar echinococcosis: a case report

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