Chirurgia del Fegato a Firenze!

Dal 1° Marzo 2023, Chirurgia del Fegato sarà all'Università di Firenze
AOUC Azienda Ospedaliero-Universitaria Careggi - Largo Brambilla, 3 - 50134 Firenze

Primo trapianto segmentario, eterotopico di fegato al mondo

Matteo Ravaioli, dell’Università di Bologna, esegue il primo trapianto segmentario, eterotopico di fegato al mondo, posizionando il graft nella loggia splenica, dopo splenectomia, e vascolarizzandolo con i vasi splenici.

L’indicazione è stata posta in un giovane paziente portatore di metastasi epatiche non resecabili da tumore colorettale.

La referenza bibliografica per questo evento è:

Matteo Ravaioli, Giovanni Brandi, Antonio Siniscalchi, Matteo Renzulli, Chiara Bonatti, Guido Fallani, Enrico Prosperi, Matteo Serenari, Giuliana Germinario, Massimo Del Gaudio, Chiara Zanfi, Federica Odaldi, Valentina Rosa Bertuzzo, Eddi Pasqualini, Lorenzo Maroni, Giacomo Frascaroli, Anna Rossetto, Maria Cristina Morelli, Luca Vizioli, Carla Serra, Gabriela Sangiorgi, Antonia D'Errico, Federico Contedini, Matteo Cescon: Heterotopic segmental liver transplantation on splenic vessels after splenectomy with delayed native hepatectomy after graft regeneration: A new technique to enhance liver transplantation. In: American Journal of Transplantation, vol. 21, no. 2, pp. 870 – 875, 2021, ISSN: 16006135, (Cited by: 9).

Abstract

We describe a patient with liver metastases from colorectal cancer treated with chemotherapy and hepatic resection, who developed unresectable multifocal liver recurrence and who received liver transplantation using a novel planned technique: heterotopic transplantation of segment 2-3 in the splenic fossa with splenectomy and delayed hepatectomy after regeneration of the transplanted graft. We transplanted a segmental liver graft after in-situ splitting without any impact on the waiting list, as it was previously rejected for pediatric and adult transplantation. The volume of the graft was insufficient to provide liver function to the recipient, so we performed this novel operation. The graft was anastomosed to the splenic vessels after splenectomy, and the native liver portal flow was modulated to enhance graft regeneration, leaving the native recipient liver intact. The volume of the graft doubled during the next 2 weeks and the native liver was removed. After 8 months, the patient lives with a functioning liver in the splenic fossa and without abdominal tumor recurrence. This is the first case reported of a segmental graft transplanted replacing the spleen and modulating the portal flow to favor graft growth, with delayed native hepatectomy. © 2020 The American Society of Transplantation and the American Society of Transplant Surgeons

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Chirurgia del Fegato all'Università di Firenze!

Chirurgia Epato-Bilio-Pancreatica

AOUC Azienda Ospedaliero-Universitaria Careggi
Largo Brambilla, 3 – 50134 Firenze

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