Pediatric living donor liver transplantation using liver allograft after backtable resection of hemangioma: A case report.

Background: Use of liver allograft with hepatic hemangioma after resection of hemangioma in living donor liver transplantation (LDLT) has been previously reported. However, there are few reports describing backtable resection of hemangioma from liver allografts in LDLT.

Case Summary: A 55-year-old male was evaluated as a donor for an 8-month-year old patient with acute hepatic failure due to biliary atresia. Pre-operative contrast enhanced computed tomography revealed a 9 cm hemangioma in segment 4 with vascular variations in the donor. During LDLT, an intra-operative intrahepatic cholangiography was performed to ensure no variation in the anatomy of the intrahepatic bile duct. After intra-operative pathological diagnosis, backtable resection of the hemangioma was performed and the liver allograft was transplanted into the recipient. The donor's and recipient's post-operative course were uneventful. At the 2-year follow-up, the liver allograft showed good regeneration without any recurrence of hemangioma.

Conclusion: Liver allografts with hemangiomas are an acceptable alternative strategy for LDLT. backtable resection of hemangioma from the donor liver during pediatric LDLT is safe and feasible, and can effectively reduce the operative time and intra-operative bleeding for the donor.