Liver graft harbouring hydatid disease: how far can we extend our donor pool?
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Liver graft harbouring hydatid disease: how far can we extend our donor pool? Anna Mrzljak 1,2 & Eva Lovric 3 & Stipislav Jadrijevic 4 & Jelena Popic 2,5 & Jadranka Pavicic-Saric 6 & Tatjana Vilibic-Cavlek 2,7 Received: 6 August 2020 / Accepted: 3 November 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract As the current demand for liver transplantation exceeds our donor pool, the donor search is shifted towards the extended donor criteria. The livers harbouring hydatid disease are a controversial source of grafts. We report the use of a liver graft harbouring hydatid disease in urgent liver transplantation in a patient with autoimmune hepatitis. Corroborated with previous experiences, we show that the liver grafts harbouring hydatid cysts provide a rare but valuable source of organs. Keywords Hydatid disease . Echinococcus . Liver graft . Liver transplant
The current demand for liver transplantation (LT) exceeds our donor pool—shifting our search inevitably ever more often towards the extended donor criteria. The marginal grafts include a wide range of conditions form steatotic livers, viral diseases (HCV RNA positive, anti-HBc positive or HIV RNA positive), benign liver tumours or hydatidosis. The livers harbouring hydatid cyst are a controversial source of grafts, and only a handful of cases have been used for LT so far˙(Bein et al. 1993; Jiménez Romero et al. 1995; Eris et al. 2013; Handling Editor: Julia Walochnik * Anna Mrzljak [email protected] 1
Department of Medicine, Merkur University Hospital, Zajceva 19, 10000 Zagreb, Croatia
2
School of Medicine, University of Zagreb, Salata 3b, 10000 Zagreb, Croatia
3
Department of Pathology, Merkur University Hospital, Zajceva 19, 10000 Zagreb, Croatia
4
Department of Surgery, Merkur University Hospital, Zajceva 19, 10000 Zagreb, Croatia
5
Department of Radiology, Merkur University Hospital, Zajceva 19, 10000 Zagreb, Croatia
6
Department of Anesthesiology and Intensive Medicine, Merkur University Hospital, Zajceva 19, 10000 Zagreb, Croatia
7
Department of Microbiology, School of Medicine, Croatian Institute of Public Health, Rockefellerova 12, 10000 Zagreb, Croatia
Patrono et al. 2017). However, despite the more demanding management, the results may be promising. Given the scarcity of the data regarding this issue, we believe that it is important to share our experience and contribute to the accumulating knowledge in this field. Echinococcosis is a zoonotic disease endemic to the Mediterranean; however, in a single liver transplant centre in Croatia with more than 1500 LT procedures over the last 25 years, only one patient received a liver graft with a previously known hydatidosis. A seroepidemiological study conducted in Croatia among patients with a cystic liver disease (2008–2009) showed the overall E. granulosus seroprevalence rate of 9% using an enzyme-linked immunosorbent assay (ELISA); however, only 3.9% were confirmed by western blot (WB) (Tabain et al. 2011). A more re
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