Infusion of CD133+ Bone Marrow–Derived Stem Cells After Selective Portal Vein Embolization Enhances Functional Hepatic Reserves After Extended Right Hepatectomy

Colorectal liver metastases (CRLM) are the major cause of death in patients with colorectal cancer (CRC). The cornerstone treatment of CRLM is surgical resection. Post-operative morbidity and mortality are mainly linked to an inadequate future liver remnant (FLR). Nowadays preoperative portal vein embolization (PVE) is the most widely performed technique to increase the size of the future liver remnant (FLR) before major hepatectomies. One method recently proposed to increase the FLR is liver venous deprivation (LVD), but its oncological impact is still unknown. The aim of this study is to report first short- and long-term oncological outcomes after LVD in patients undergoing right (or extended right) hepatectomy for CRLM. Seventeen consecutive patients undergoing LVD between July 2015 and May 2020 before an (extended) right hepatectomy were retrospectively analyzed from an institutional database. Post-operative and follow-up data were analyzed and reported. Primary outcomes were 1-year and 3-year overall survival (OS) and hepatic recurrence (HR). Postoperative complications occurred in 8 patients (47%). No deaths occurred after surgery. HR occurred in 9 patients (52.9%). 1-year and 3-year OS were 87% (95% confidence interval [CI]: ±16%) and 60.3%, respectively (95% CI: ±23%). Median Disease-Free Survival (DFS) was 6 months (CI 95%: 4.7–7.2). With all the limitations of a retrospective study with a small sample size, LVD showed similar oncological outcomes compared to literature reports for Portal Vein Embolization (PVE).

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Portal Vein Embolization and Autologous CD133+Bone Marrow Stem Cells for Liver Regeneration: Initial Experience

Radiology ◽

10.1148/radiol.2431060625 ◽

2007 ◽

Vol 243 (1) ◽

pp. 171-179 ◽

Cited By ~ 108

Author(s):

Günter Fürst ◽

Jan Schulte am Esch ◽

Ludger W. Poll ◽

Stefan B. Hosch ◽

L. Benjamin Fritz ◽

...

Keyword(s):

Stem Cells ◽

Bone Marrow ◽

Portal Vein ◽

Liver Regeneration ◽

Portal Vein Embolization ◽

Bone Marrow Stem Cells ◽

Initial Experience

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Portal Vein Embolization before Right Hepatectomy or Extended Right Hepatectomy Using Sodium Tetradecyl Sulfate Foam: Technique and Initial Results

Journal of Vascular and Interventional Radiology ◽

10.1016/j.jvir.2014.01.034 ◽

2014 ◽

Vol 25 (7) ◽

pp. 1045-1053 ◽

Cited By ~ 14

Author(s):

Aaron M. Fischman ◽

Thomas J. Ward ◽

Jeremy C. Horn ◽

Edward Kim ◽

Rahul S. Patel ◽

...

Keyword(s):

Portal Vein ◽

Portal Vein Embolization ◽

Sodium Tetradecyl Sulfate ◽

Right Hepatectomy ◽

Extended Right Hepatectomy ◽

Initial Results

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A Comparison of Portal Vein Embolization With Poly(2-hydroxyethylmethacrylate) and a Histoacryl/Lipiodol Mixture in Patients Scheduled for Extended Right Hepatectomy

Physiological Research ◽

10.33549/physiolres.932992 ◽

2015 ◽

pp. 841-848 ◽

Cited By ~ 1

Author(s):

J. H. PEREGRIN ◽

R. JANOUŠEK ◽

D. KAUTZNEROVÁ ◽

M. OLIVERIUS ◽

E. STICOVÁ ◽

...

Keyword(s):

Portal Vein ◽

Portal Vein Embolization ◽

Future Liver Remnant ◽

Right Hepatectomy ◽

Portal Vein Branch ◽

Liver Remnant ◽

Extended Right Hepatectomy ◽

The Right ◽

Transhepatic Access ◽

Flr Hypertrophy

ght hepatectomy and whether it is as effective as the currently used agent (a histoacryl/lipiodol mixture). Two groups of nine patients each scheduled for extended right hepatectomy for primary or secondary hepatic tumor, had right portal vein embolization in an effort to induce future liver remnant (FLR) hypertrophy. One group had embolization with PHEMA, the other one with the histoacryl/lipiodol mixture. In all patients, embolization was performed using the right retrograde transhepatic access. Embolization was technically successful in all 18 patients, with no complication related to the embolization agent. Eight patients of either group developed FLR hypertrophy allowing extended right hepatectomy. Likewise, one patient in each group had recanalization of a portal vein branch. Histology showed that both embolization agents reach the periphery of portal vein branches, with PHEMA penetrating somewhat deeper into the periphery. PHEMA has been shown to be an agent suitable for embolization in the portal venous system comparable with existing embolization agent (histoacryl/lipiodol mixture).

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