TRANSPLANTATION TECHNOLOGIES FOR SURGICAL TREATMENT OF THE LOCALLY ADVANCED HEPATIC ALVEOCOCCOSIS WITH INVASION INTO GREAT VESSELS

Aim. To study the opportunities, immediate and long-term results of surgical treatment of locally advanced hepatic alveococcosis with invasion into great vessels. Material and Methods. The study included 63 patients. There were 19 liver transplantations, 12 normothermal liver autotransplantations (ante situm), 1 hypothermic liver autotransplantation (ex situ ex vivo) and 31 extended liver resections with resection and repair of great vessels. Results. Overall morbidity after liver transplantation was 31.6%, after normothermic liver autotransplantations — 38.5%, after extended liver resections with resection and repair of great vessels — 25.8%. Mortality after liver transplantation was 5.3% (1 patient). There was no in-hospital mortality after liver autotransplantations and after extended liver resections with resection and repair of great vessels. Maximal follow-up after liver transplantation was 54 months, after liver autotransplantations — 38 months, after extended liver resections with resection and repair of great vessels — 40 months. Long-term mortality was absent. Median survival was 21 months. Conclusion. Transplantation techniques in liver surgery can be recognized as an important and new surgical strategy in the treatment of unresectable hepatic alveolar echinococcosis. Excellent immediate and long-term results of radical surgery for locally advanced hepatic alveolar echinococcosis using transplantation technologies emphasize justification to concentrate these patients in highly specialized centers.