Abstract
Living donor liver transplantation (LTx) for hepatoblastoma (HB) involving the inferior vena cava (IVC) is still challenging, because it may require veno-venous bypass (vvbp) utilizing extracorporeal circulation and vascular reconstruction. We herein report three cases of HB involving the IVC and discuss our surgical strategies. Case 1 is an 18-month-old boy diagnosed as having POSTEXT IV HB, which extended to the right atrium and the suprahepatic IVC. A living donor LTx was performed utilizing vvbp, and an autopericardial patch graft was used for the reconstruction of the IVC. Case 2 is a 7-month-old boy who presented with POSTEXT IV HB, which obstructed the IVC completely. Blood from the lower part of the body returned to the right atrium through the intrahepatic shunt. The IVC was replaced with a superficial femoral vein from a donor at the time of LTx. Case 3 is an 8-month-old boy diagnosed as having POSTEXT II HB, which involved the IVC, and who underwent LTx. Vvbp was utilized at the time of hepatectomy to avoid the rupture of the tumor. All three patients have been recurrence-free for 16–33 months since the LTx.
