Table 1_Case report: Outflow reconstruction with pre-frozen allograft blood vessels during in vivo partial hepatectomy followed by ex vivo tumor resection and partial liver autotransplantation for locally advanced hepatocellular carcinoma with background of cirrhosis.docx

Ex vivo surgery and autotransplantation may provide a promising option for radical resection of conventionally unresectable liver tumors. Two cirrhotic patients with hepatocellular carcinoma (HCC), which has an “awkward seat” located in the “intrahepatic vascular triangle area (IVTA)” that consists of the middle hepatic vein (MHV), the right branches of the Glisson sheath, and the inferior vena cava (IVC), underwent in vivo extended right-half hepatectomy followed by ex vivo tumor resection and partial liver autotransplantation. Innovatively, the outflow of the tumor-free liver was reconstructed ex vivo using pre-frozen allograft blood vessels from brain-dead donors; the patients recovered well postoperation. We report the surgical experience to provide a novel curable surgical procedure for locally advanced IVTA liver tumors.

离体手术（ex vivo surgery）联合自体移植（autotransplantation），可为常规不可切除肝肿瘤的根治性切除提供极具前景的治疗选择。本文报告2例肝硬化合并肝细胞癌（hepatocellular carcinoma, HCC）患者，其肿瘤位于由肝中静脉（middle hepatic vein, MHV）、格利森鞘（Glisson sheath）右支及下腔静脉（inferior vena cava, IVC）构成的肝内血管三角区（intrahepatic vascular triangle area, IVTA），位置刁钻。2例患者均接受了在体扩大右半肝切除术，随后行离体肿瘤切除及部分肝自体移植（partial liver autotransplantation）。本次手术创新性地采用脑死亡供者（brain-dead donors）的预冻同种异体血管（pre-frozen allograft blood vessels），在体外完成无瘤肝脏的流出道重建；术后患者恢复良好。本文详述该手术经验，旨在为局部晚期肝内血管三角区肝肿瘤提供一种全新的可治愈手术方案。