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.	董家鸿, 蔡景修, 段恒春, 等. 全肝血液转流及冷灌注下的离体肝切除术: 动物实验和病例报告. 肝胆外科杂志, 1997, 5(4): 209-213.
3.	温浩, 黄洁夫, 张金辉, 等. 体外肝肿瘤切除加自体肝移植术治疗肝内胆管细胞癌一例. 中华外科杂志, 2006, 44(9): 642-644.
4.	温浩, 董家鸿, 张金辉, 等. 体外肝切除联合自体肝移植治疗肝泡型包虫病. 中华消化外科杂志, 2011, 10(2): 148-149.
5.	吐尔洪江·吐逊, 阿卜杜萨拉木·艾尼, 李玉鹏, 等. 非原位肝切除技术安全性、可行性和有效性的系统评价. 中华医学杂志, 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.	杨文昊, 廖玉波, 黄良, 等. “在体优先”的离体肝切除联合自体肝移植术治疗晚期肝泡型包虫病的应用效果. 中国普外基础与临床杂志, 2022, 29(10): 1308-1312.
11.	张宇, 杨冲, 王燚, 等. 原位保留部分残余肝脏的离体肝切除联合辅助性自体肝移植治疗复杂肝泡型包虫病. 中国普外基础与临床杂志, 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.	达瓦, 张隽, 索朗多杰, 等. 术前三维重建可视化数字技术在西藏地区肝包虫病手术治疗中的应用. 中华肝胆外科杂志, 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.	黄良, 张娜, 杨冲, 等. 多种血管材料重建肝静脉在离体肝脏切除联合自体肝脏移植治疗晚期肝包虫病中的应用. 中国普外基础与临床杂志, 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.	张博雅, 吴迪. 自体肝移植现状及进展. 中华器官移植杂志, 2021, 42(12): 761-764.
24.	项捷, 厉智威, 张微, 等. 供器官短缺时代肝移植手术和管理模式的思考. 实用器官移植电子杂志, 2022, 10(4): 295-300, 288.
25.	梁廷波, 王晓光. 肝癌肝移植和肝切除的卫生经济学及生命质量评估. 中华消化外科杂志, 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.	张健, 林俊, 沈洪亮, 等. 自体大隐静脉逆转替代肾动脉或肾静脉自体肾移植二例. 中华移植杂志 (电子版), 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.	庞北川, 张娜, 杨冲, 等. 原位自体肾移植联合下腔静脉切除重建在腹膜后肿瘤中的应用. 中国普外基础与临床杂志, 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. 董家鸿, 蔡景修, 段恒春, 等. 全肝血液转流及冷灌注下的离体肝切除术: 动物实验和病例报告. 肝胆外科杂志, 1997, 5(4): 209-213.
3. 温浩, 黄洁夫, 张金辉, 等. 体外肝肿瘤切除加自体肝移植术治疗肝内胆管细胞癌一例. 中华外科杂志, 2006, 44(9): 642-644.
4. 温浩, 董家鸿, 张金辉, 等. 体外肝切除联合自体肝移植治疗肝泡型包虫病. 中华消化外科杂志, 2011, 10(2): 148-149.
5. 吐尔洪江·吐逊, 阿卜杜萨拉木·艾尼, 李玉鹏, 等. 非原位肝切除技术安全性、可行性和有效性的系统评价. 中华医学杂志, 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. 杨文昊, 廖玉波, 黄良, 等. “在体优先”的离体肝切除联合自体肝移植术治疗晚期肝泡型包虫病的应用效果. 中国普外基础与临床杂志, 2022, 29(10): 1308-1312.
11. 张宇, 杨冲, 王燚, 等. 原位保留部分残余肝脏的离体肝切除联合辅助性自体肝移植治疗复杂肝泡型包虫病. 中国普外基础与临床杂志, 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. 达瓦, 张隽, 索朗多杰, 等. 术前三维重建可视化数字技术在西藏地区肝包虫病手术治疗中的应用. 中华肝胆外科杂志, 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. 黄良, 张娜, 杨冲, 等. 多种血管材料重建肝静脉在离体肝脏切除联合自体肝脏移植治疗晚期肝包虫病中的应用. 中国普外基础与临床杂志, 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. 张博雅, 吴迪. 自体肝移植现状及进展. 中华器官移植杂志, 2021, 42(12): 761-764.
24. 项捷, 厉智威, 张微, 等. 供器官短缺时代肝移植手术和管理模式的思考. 实用器官移植电子杂志, 2022, 10(4): 295-300, 288.
25. 梁廷波, 王晓光. 肝癌肝移植和肝切除的卫生经济学及生命质量评估. 中华消化外科杂志, 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. 张健, 林俊, 沈洪亮, 等. 自体大隐静脉逆转替代肾动脉或肾静脉自体肾移植二例. 中华移植杂志 (电子版), 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. 庞北川, 张娜, 杨冲, 等. 原位自体肾移植联合下腔静脉切除重建在腹膜后肿瘤中的应用. 中国普外基础与临床杂志, 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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