Experience of perioperative anesthesiological support for successful ex situ, ex vivo liver resection, and autotransplantation in a patient with giant tumor of left liver lobe

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This article presents a clinical case of the first successful autotransplantation of the liver at the P.A. Herzen Moscow Oncological Research Institute, accompanied by massive blood loss and severe post-resection liver failure. The patient diagnosed with «stage IIIB hepatocellular carcinoma, T4N0M0» was admitted for surgical treatment. According to abdominal computed tomography, the left lobe of the liver was completely replaced by a lesion measuring 25x14x24 cm. Given the localization and spread of the tumor process, a decision was made to perform an extracorporeal stage of liver resection followed by autotransplantation. The intraoperative period was complicated by massive blood loss of 19.000 ml. In the early postoperative period, the patient was diagnosed with severe post-resection liver failure, requiring correction with extracorporeal detoxification methods (ultrahemodiafiltration, plasmapheresis). On the 17th day, the patient was transferred to a general ward in satisfactory condition and discharged from the clinic after 28 days.

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