PADUA. Professor Umberto Cillo, Director of Hepatobiliary Surgery and hepatic transplantations in Padua’s Universitary Hospital, performed with his staff an innovative surgery in Oncology transplantation’s environment. Surgery was performed on a 47 years old patient suffering from multiple liver metastases caused by unresectable colon cancer, and the high number of metastases affecting all of the liver segments.
The surgery took place in two stages: in the first stage a small piece of liver donated by a family member was transplanted along by the diseased liver. After the growth of the donated fragment, that in 17 days reached a sufficient volume to sustain life, in the second stage the patient’s metastatic liver was removed for the first time ever in Padua with minimally invasive technique in videolaparoscopy. The team, made up of over 20 professional experts among surgeons, anesthetists, perfusion technicians, scrub nurses, and operating room assistants, has performed the extremely delicate surgery combining three highly specialized surgical techniques: removing half of the liver affected by metastasis, auxiliary liver transplantation in place the portion donated (alongside the diseased liver) and lastly the diseased liver remnant’s removal by videolaparoscopy after getting a regeneration up to more than twice the volume of the donated liver’s fragment. Another important feature of the project is that the auxiliary liver transplantation coming from a living donor, was executed by the technique RAPID: the right branch of Portal vein of receiver is interrupted to ensure all blood supply to the left lobe transplanted stimulating rapid (RAPID) liver regeneration, which occurs in about 17 days.
This technique could be a major breakthrough in liver transplants for patients with unresectable metastases from colorectal cancer, currently entrusted to chemotherapy alone currently entrusted to chemotherapy alone, and a unique source of additional donation to that available today, distinguished by a very low risk of complications for living donors, given the low percentage of liver donated (only 20%).
