Application and progress of common autologous organ transplantation techniques_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

PANG Beichuan ¹ , LIAO Yubo ² , HUANG Liang ² ,  ZHANG Yu ^1,3

1. School of Medicine, University of Electronic Science and Technology of China, Chengdu 610054, P. R. China;
2. Chengdu Medical College Clinical Medicine College, Chengdu 610500, P. R. China;
3. Department of Hepatobiliary and Pancreatic Surgery, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu 610072, P. R. China;

Corresponding?author：

ZHANG Yu, Email: zhangyuqg@med.uestc.edu.cn

Keywords：

autologous organ transplantation; radical resection; organ cluster; ex-vivo infusion

DOI：

10.7507/1007-9424.202303070

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To summarize the application and progress of common autologous organ transplantation (AOT) techniques. Method A literature review and summary of previous and recent studies on common AOT was performed, including autologous liver transplantation, autologous kidney transplantation and intestinal autotransplantation techniques. Results AOT solved the issues of bleeding that cannot be controlled by in vivo resection of lesions, difficulties in vascular reconstruction, and the inability to radically resect lesions, and extended the indications for treatment of partially diseased conditions. Conclusions The AOT technique has an ameliorating effect on the tight donor situation in China, providing more potential donors. And the application of the AOT technique effectively avoids the usage of postoperative immunosuppressive drugs and the progression of lesions due to waiting for allogeneic organ transplantation. However, the clinical benefit in malignant tumors remains to be further investigated.

Citation： PANG Beichuan, LIAO Yubo, HUANG Liang, ZHANG Yu. Application and progress of common autologous organ transplantation techniques. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2023, 30(9): 1119-1123. doi: 10.7507/1007-9424.202303070 Copy

1.	Pichlmayr R, Grosse H, Hauss J, et al. Technique and preliminary results of extracorporeal liver surgery (bench procedure) and of surgery on the in situ perfused liver. Br J Surg, 1990, 77(1): 21-26.
2.	董家鴻, 蔡景修, 段恒春, 等. 全肝血液轉流及冷灌注下的離體肝切除術: 動物實驗和病例報告. 肝膽外科雜志, 1997, 5(4): 209-213.
3.	溫浩, 黃潔夫, 張金輝, 等. 體外肝腫瘤切除加自體肝移植術治療肝內膽管細胞癌一例. 中華外科雜志, 2006, 44(9): 642-644.
4.	溫浩, 董家鴻, 張金輝, 等. 體外肝切除聯合自體肝移植治療肝泡型包蟲病. 中華消化外科雜志, 2011, 10(2): 148-149.
5.	吐爾洪江·吐遜, 阿卜杜薩拉木·艾尼, 李玉鵬, 等. 非原位肝切除技術安全性、可行性和有效性的系統評價. 中華醫學雜志, 2016, 96(28): 2251-2257.
6.	Qiu Y, Yang X, Shen S, et al. Vascular infiltration-based surgical planning in treating end-stage hepatic alveolar echinococcosis with ex vivo liver resection and autotransplantation. Surgery, 2019, 165(5): 889-896.
7.	Yang X, Qiu Y, Huang B, et al. Novel techniques and preliminary results of ex vivo liver resection and autotransplantation for end-stage hepatic alveolar echinococcosis: a study of 31 cases. Am J Transplant, 2018, 18(7): 1668-1679.
8.	Hannoun L, Panis Y, Balladur P, et al. Ex-situ in-vivo liver surgery. Lancet, 1991, 337(8757): 1616-1617.
9.	Sauvanet A, Dousset B, Belghiti J. A simplified technique of ex situ hepatic surgical treatment. J Am Coll Surg, 1994, 178(1): 79-82.
10.	楊文昊, 廖玉波, 黃良, 等. “在體優先”的離體肝切除聯合自體肝移植術治療晚期肝泡型包蟲病的應用效果. 中國普外基礎與臨床雜志, 2022, 29(10): 1308-1312.
11.	張宇, 楊沖, 王燚, 等. 原位保留部分殘余肝臟的離體肝切除聯合輔助性自體肝移植治療復雜肝泡型包蟲病. 中國普外基礎與臨床雜志, 2019, 26(8): 974-979.
12.	Jianyong L, Jingcheng H, Wentao W, et al. Ex vivo liver resection followed by autotransplantation to a patient with advanced alveolar echinococcosis with a replacement of the retrohepatic inferior vena cava using autogenous vein grafting: a case report and literature review. Medicine (Baltimore), 2015, 94(7): e514. doi: 10.1097/MD.0000000000000514.
13.	Shen S, Qiu Y, Yang X, et al. Remnant liver-to-standard liver volume ratio below 40% is safe in ex vivo liver resection and autotransplantation. J Gastrointest Surg, 2019, 23(10): 1964-1972.
14.	Yang C, Yang HJ, Deng SP, et al. Current status of ex-vivo liver resection and autologous liver transplantation for end-stage hepatic alveolar echinococcosis. Ann Palliat Med, 2020, 9(4): 2271-2278.
15.	Wen H, Dong JH, Zhang JH, et al. Ex vivo liver resection and autotransplantation for end-stage alveolar echinococcosis: a case series. Am J Transplant, 2016, 16(2): 615-624.
16.	George A, Rammohan A, Reddy SM, et al. Ex situ liver resection and autotransplantation for advanced cholangiocarcinoma. BMJ Case Rep, 2019, 12(8): e230808. doi: 10.1136/bcr-2019-230808.
17.	達瓦, 張雋, 索朗多杰, 等. 術前三維重建可視化數字技術在西藏地區肝包蟲病手術治療中的應用. 中華肝膽外科雜志, 2021, 27(8): 575-578.
18.	Chen J, Wei L, Chen TW, et al. Triphase contrast-enhanced CT to evaluate indications for autologous liver transplantation in patients with end-stage hepatic alveolar echinococcosis. Sci Rep, 2021, 11(1): 22096. doi: 10.1038/s41598-021-01586-8.
19.	Zhang Y, Yang C, Yang H, et al. Comment on “the value of hepatic vein stent placement as a bridge therapy on treating hepatic alveolar echinococcosis presenting with budd-chiari syndrome”. Ann Surg, 2021, 274(6): e923-e924.
20.	Liang Y, Zhang Z, Dai Z, et al. Comparative study of indocyanine green (ICG)-R15 and Albumin-Indocyanine Green Evaluation (ALICE) grading system in the prediction of posthepatectomy liver failure and postoperative mortality in patients with hepatic alveolar echinococcosis. BMC Gastroenterol, 2022, 22(1): 297. doi: 10.1186/s12876-022-02367-x.
21.	黃良, 張娜, 楊沖, 等. 多種血管材料重建肝靜脈在離體肝臟切除聯合自體肝臟移植治療晚期肝包蟲病中的應用. 中國普外基礎與臨床雜志, 2022, 29(9): 1169-1173.
22.	Ye Q, Zeng C, Wang Y, et al. Long-term outcomes of ante-situm resection and auto-transplantation in conventionally unresectable hepatocellular carcinoma: a single-center experience. Ann Transplant, 2018, 23: 81-88.
23.	張博雅, 吳迪. 自體肝移植現狀及進展. 中華器官移植雜志, 2021, 42(12): 761-764.
24.	項捷, 厲智威, 張微, 等. 供器官短缺時代肝移植手術和管理模式的思考. 實用器官移植電子雜志, 2022, 10(4): 295-300, 288.
25.	梁廷波, 王曉光. 肝癌肝移植和肝切除的衛生經濟學及生命質量評估. 中華消化外科雜志, 2010, 9(1): 15-17.
26.	Aji T, Dong JH, Shao YM, et al. Ex vivo liver resection and autotransplantation as alternative to allotransplantation for end-stage hepatic alveolar echinococcosis. J Hepatol, 2018, 69(5): 1037-1046.
27.	Hardy JD. High ureteral injuries. Management by autotransplantation of the kidney. JAMA, 1963, 184: 97-101.
28.	Azhar B, Patel S, Chadha P, et al. Indications for renal autotransplant: an overview. Exp Clin Transplant, 2015, 13(2): 109-114.
29.	Moghadamyeghaneh Z, Hanna MH, Fazlalizadeh R, et al. A nationwide analysis of kidney autotransplantation. Am Surg, 2017, 83(2): 162-169.
30.	張健, 林俊, 沈洪亮, 等. 自體大隱靜脈逆轉替代腎動脈或腎靜脈自體腎移植二例. 中華移植雜志 (電子版), 2021, 15(2): 101-104.
31.	Alameddine M, Moghadamyeghaneh Z, Yusufali A, et al. Kidney autotransplantation: between the past and the future. Curr Urol Rep, 2018, 19(3): 7. doi: 10.1007/s11934-018-0749-4.
32.	龐北川, 張娜, 楊沖, 等. 原位自體腎移植聯合下腔靜脈切除重建在腹膜后腫瘤中的應用. 中國普外基礎與臨床雜志, 2022, 29(8): 1018-1023.
33.	Wu X, Wang W, Li Q, et al. Current situation with organ donation and transplantation in China: application of machine learning. Transplant Proc, 2022, 54(7): 1711-1723.
34.	Han DS, Johnson JP, Schulster ML, et al. Indications for and results of renal autotransplantation. Curr Opin Nephrol Hypertens, 2023, 32(2): 183-192.
35.	Lai DT, Chu KM, Thompson JF, et al. Islet cell carcinoma treated by induction regional chemotherapy and radical total pancreatectomy with liver revascularization and small bowel autotransplantation. Surgery, 1996, 119(1): 112-114.
36.	Tzakis AG, De Faria W, Angelis M, et al. Partial abdominal exenteration, ex vivo resection of a large mesenteric fibroma, and successful orthotopic intestinal autotransplantation. Surgery, 2000, 128(3): 486-489.
37.	Bockhorn M, Uzunoglu FG, Adham M, et al. Borderline resectable pancreatic cancer: a consensus statement by the International Study Group of Pancreatic Surgery (ISGPS). Surgery, 2014, 155(6): 977-988.
38.	Wu G. Intestinal autotransplantation. Gastroenterol Rep (Oxf), 2017, 5(4): 258-265.
39.	Wu G, Wang X, Zhao Q, et al. Intestinal autotransplantation for neoplasms originating in the pancreatic head with involvement of the superior mesenteric artery. Langenbecks Arch Surg, 2016, 401(8): 1249-1257.
40.	Wu G, Zhao Q, Wang W, et al. Clinical and nutritional outcomes after intestinal autotransplantation. Surgery, 2016, 159(6): 1668-1676.
41.	Benedetti E, Holterman M, Asolati M, et al. Living related segmental bowel transplantation: from experimental to standardized procedure. Ann Surg, 2006, 244(5): 694-699.
42.	Wu G, Liu C, Zhou X, et al. Living donor intestinal transplantation: recipient outcomes. Ann Surg, 2022, 276(5): e444-e449.
43.	Nikeghbalian S, Aliakbarian M, Kazemi K, et al. Ex-vivo resection and small-bowel auto-transplantation for the treatment of tumors at the root of the mesentery. Int J Organ Transplant Med, 2014, 5(3): 120-124.
44.	Liang T, Zhang Q, Wu G, et al. Radical resection combined with intestinal autotransplantation for locally advanced pancreatic cancer after neoadjuvant therapy: a report of 36 consecutive cases. Ann Surg, 2023 Jan 24. doi: 10.1097/SLA.0000000000005797.
45.	Chan DKH, Lee SKF, Ang JJ. Indocyanine green fluorescence angiography decreases the risk of colorectal anastomotic leakage: systematic review and meta-analysis. Surgery, 2020, 168(6): 1128-1137.
46.	Alemanno G, Somigli R, Prosperi P, et al. Combination of diagnostic laparoscopy and intraoperative indocyanine green fluorescence angiography for the early detection of intestinal ischemia not detectable at CT scan. Int J Surg Case Rep, 2016, 26: 77-80.

1. Pichlmayr R, Grosse H, Hauss J, et al. Technique and preliminary results of extracorporeal liver surgery (bench procedure) and of surgery on the in situ perfused liver. Br J Surg, 1990, 77(1): 21-26.
2. 董家鴻, 蔡景修, 段恒春, 等. 全肝血液轉流及冷灌注下的離體肝切除術: 動物實驗和病例報告. 肝膽外科雜志, 1997, 5(4): 209-213.
3. 溫浩, 黃潔夫, 張金輝, 等. 體外肝腫瘤切除加自體肝移植術治療肝內膽管細胞癌一例. 中華外科雜志, 2006, 44(9): 642-644.
4. 溫浩, 董家鴻, 張金輝, 等. 體外肝切除聯合自體肝移植治療肝泡型包蟲病. 中華消化外科雜志, 2011, 10(2): 148-149.
5. 吐爾洪江·吐遜, 阿卜杜薩拉木·艾尼, 李玉鵬, 等. 非原位肝切除技術安全性、可行性和有效性的系統評價. 中華醫學雜志, 2016, 96(28): 2251-2257.
6. Qiu Y, Yang X, Shen S, et al. Vascular infiltration-based surgical planning in treating end-stage hepatic alveolar echinococcosis with ex vivo liver resection and autotransplantation. Surgery, 2019, 165(5): 889-896.
7. Yang X, Qiu Y, Huang B, et al. Novel techniques and preliminary results of ex vivo liver resection and autotransplantation for end-stage hepatic alveolar echinococcosis: a study of 31 cases. Am J Transplant, 2018, 18(7): 1668-1679.
8. Hannoun L, Panis Y, Balladur P, et al. Ex-situ in-vivo liver surgery. Lancet, 1991, 337(8757): 1616-1617.
9. Sauvanet A, Dousset B, Belghiti J. A simplified technique of ex situ hepatic surgical treatment. J Am Coll Surg, 1994, 178(1): 79-82.
10. 楊文昊, 廖玉波, 黃良, 等. “在體優先”的離體肝切除聯合自體肝移植術治療晚期肝泡型包蟲病的應用效果. 中國普外基礎與臨床雜志, 2022, 29(10): 1308-1312.
11. 張宇, 楊沖, 王燚, 等. 原位保留部分殘余肝臟的離體肝切除聯合輔助性自體肝移植治療復雜肝泡型包蟲病. 中國普外基礎與臨床雜志, 2019, 26(8): 974-979.
12. Jianyong L, Jingcheng H, Wentao W, et al. Ex vivo liver resection followed by autotransplantation to a patient with advanced alveolar echinococcosis with a replacement of the retrohepatic inferior vena cava using autogenous vein grafting: a case report and literature review. Medicine (Baltimore), 2015, 94(7): e514. doi: 10.1097/MD.0000000000000514.
13. Shen S, Qiu Y, Yang X, et al. Remnant liver-to-standard liver volume ratio below 40% is safe in ex vivo liver resection and autotransplantation. J Gastrointest Surg, 2019, 23(10): 1964-1972.
14. Yang C, Yang HJ, Deng SP, et al. Current status of ex-vivo liver resection and autologous liver transplantation for end-stage hepatic alveolar echinococcosis. Ann Palliat Med, 2020, 9(4): 2271-2278.
15. Wen H, Dong JH, Zhang JH, et al. Ex vivo liver resection and autotransplantation for end-stage alveolar echinococcosis: a case series. Am J Transplant, 2016, 16(2): 615-624.
16. George A, Rammohan A, Reddy SM, et al. Ex situ liver resection and autotransplantation for advanced cholangiocarcinoma. BMJ Case Rep, 2019, 12(8): e230808. doi: 10.1136/bcr-2019-230808.
17. 達瓦, 張雋, 索朗多杰, 等. 術前三維重建可視化數字技術在西藏地區肝包蟲病手術治療中的應用. 中華肝膽外科雜志, 2021, 27(8): 575-578.
18. Chen J, Wei L, Chen TW, et al. Triphase contrast-enhanced CT to evaluate indications for autologous liver transplantation in patients with end-stage hepatic alveolar echinococcosis. Sci Rep, 2021, 11(1): 22096. doi: 10.1038/s41598-021-01586-8.
19. Zhang Y, Yang C, Yang H, et al. Comment on “the value of hepatic vein stent placement as a bridge therapy on treating hepatic alveolar echinococcosis presenting with budd-chiari syndrome”. Ann Surg, 2021, 274(6): e923-e924.
20. Liang Y, Zhang Z, Dai Z, et al. Comparative study of indocyanine green (ICG)-R15 and Albumin-Indocyanine Green Evaluation (ALICE) grading system in the prediction of posthepatectomy liver failure and postoperative mortality in patients with hepatic alveolar echinococcosis. BMC Gastroenterol, 2022, 22(1): 297. doi: 10.1186/s12876-022-02367-x.
21. 黃良, 張娜, 楊沖, 等. 多種血管材料重建肝靜脈在離體肝臟切除聯合自體肝臟移植治療晚期肝包蟲病中的應用. 中國普外基礎與臨床雜志, 2022, 29(9): 1169-1173.
22. Ye Q, Zeng C, Wang Y, et al. Long-term outcomes of ante-situm resection and auto-transplantation in conventionally unresectable hepatocellular carcinoma: a single-center experience. Ann Transplant, 2018, 23: 81-88.
23. 張博雅, 吳迪. 自體肝移植現狀及進展. 中華器官移植雜志, 2021, 42(12): 761-764.
24. 項捷, 厲智威, 張微, 等. 供器官短缺時代肝移植手術和管理模式的思考. 實用器官移植電子雜志, 2022, 10(4): 295-300, 288.
25. 梁廷波, 王曉光. 肝癌肝移植和肝切除的衛生經濟學及生命質量評估. 中華消化外科雜志, 2010, 9(1): 15-17.
26. Aji T, Dong JH, Shao YM, et al. Ex vivo liver resection and autotransplantation as alternative to allotransplantation for end-stage hepatic alveolar echinococcosis. J Hepatol, 2018, 69(5): 1037-1046.
27. Hardy JD. High ureteral injuries. Management by autotransplantation of the kidney. JAMA, 1963, 184: 97-101.
28. Azhar B, Patel S, Chadha P, et al. Indications for renal autotransplant: an overview. Exp Clin Transplant, 2015, 13(2): 109-114.
29. Moghadamyeghaneh Z, Hanna MH, Fazlalizadeh R, et al. A nationwide analysis of kidney autotransplantation. Am Surg, 2017, 83(2): 162-169.
30. 張健, 林俊, 沈洪亮, 等. 自體大隱靜脈逆轉替代腎動脈或腎靜脈自體腎移植二例. 中華移植雜志 (電子版), 2021, 15(2): 101-104.
31. Alameddine M, Moghadamyeghaneh Z, Yusufali A, et al. Kidney autotransplantation: between the past and the future. Curr Urol Rep, 2018, 19(3): 7. doi: 10.1007/s11934-018-0749-4.
32. 龐北川, 張娜, 楊沖, 等. 原位自體腎移植聯合下腔靜脈切除重建在腹膜后腫瘤中的應用. 中國普外基礎與臨床雜志, 2022, 29(8): 1018-1023.
33. Wu X, Wang W, Li Q, et al. Current situation with organ donation and transplantation in China: application of machine learning. Transplant Proc, 2022, 54(7): 1711-1723.
34. Han DS, Johnson JP, Schulster ML, et al. Indications for and results of renal autotransplantation. Curr Opin Nephrol Hypertens, 2023, 32(2): 183-192.
35. Lai DT, Chu KM, Thompson JF, et al. Islet cell carcinoma treated by induction regional chemotherapy and radical total pancreatectomy with liver revascularization and small bowel autotransplantation. Surgery, 1996, 119(1): 112-114.
36. Tzakis AG, De Faria W, Angelis M, et al. Partial abdominal exenteration, ex vivo resection of a large mesenteric fibroma, and successful orthotopic intestinal autotransplantation. Surgery, 2000, 128(3): 486-489.
37. Bockhorn M, Uzunoglu FG, Adham M, et al. Borderline resectable pancreatic cancer: a consensus statement by the International Study Group of Pancreatic Surgery (ISGPS). Surgery, 2014, 155(6): 977-988.
38. Wu G. Intestinal autotransplantation. Gastroenterol Rep (Oxf), 2017, 5(4): 258-265.
39. Wu G, Wang X, Zhao Q, et al. Intestinal autotransplantation for neoplasms originating in the pancreatic head with involvement of the superior mesenteric artery. Langenbecks Arch Surg, 2016, 401(8): 1249-1257.
40. Wu G, Zhao Q, Wang W, et al. Clinical and nutritional outcomes after intestinal autotransplantation. Surgery, 2016, 159(6): 1668-1676.
41. Benedetti E, Holterman M, Asolati M, et al. Living related segmental bowel transplantation: from experimental to standardized procedure. Ann Surg, 2006, 244(5): 694-699.
42. Wu G, Liu C, Zhou X, et al. Living donor intestinal transplantation: recipient outcomes. Ann Surg, 2022, 276(5): e444-e449.
43. Nikeghbalian S, Aliakbarian M, Kazemi K, et al. Ex-vivo resection and small-bowel auto-transplantation for the treatment of tumors at the root of the mesentery. Int J Organ Transplant Med, 2014, 5(3): 120-124.
44. Liang T, Zhang Q, Wu G, et al. Radical resection combined with intestinal autotransplantation for locally advanced pancreatic cancer after neoadjuvant therapy: a report of 36 consecutive cases. Ann Surg, 2023 Jan 24. doi: 10.1097/SLA.0000000000005797.
45. Chan DKH, Lee SKF, Ang JJ. Indocyanine green fluorescence angiography decreases the risk of colorectal anastomotic leakage: systematic review and meta-analysis. Surgery, 2020, 168(6): 1128-1137.
46. Alemanno G, Somigli R, Prosperi P, et al. Combination of diagnostic laparoscopy and intraoperative indocyanine green fluorescence angiography for the early detection of intestinal ischemia not detectable at CT scan. Int J Surg Case Rep, 2016, 26: 77-80.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Application and progress of common autologous organ transplantation techniques

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