LIVER ALLOTRANSPLANTATION FOR END-STAGE HEPATIC ALVEOCOCCOSIS, WITH CIRCULAR GERMINATION OF THE PARASITE TO THE INTRAHEPATIC SEGMENT OF THE INFERIOR VENA CAVA, AS AN ALTERNATIVE TO LIVER TRANSPLANTATION

To improve the results of surgical treatment of liver alveococcosis, an analysis of the results of surgical interventions in 23 patients to remove liver alveococcosis was carried out in the period from 2013 to 2023. Four patients were operated on with alveolar echinococcosis spreading into the intrahepatic segment of the inferior vena cava. All cases of parasite germination into vascular structures required resection of the latter with prosthetics with vascular alloprostheses. In one case with damage to the inferior vena cava up to a critical circular narrowing of up to 5 mm. The parasite was removed from the liver, outside the patient’s body with the formation of vascular elements on the “Back Table”. Performing liver allotransplantation with resection and plastic surgery of the great vessels, including resection of the inferior vena cava, can serve as the only radical method of treating “unresectable” alveococcosis of the liver, allowing for satisfactory immediate and long-term results of surgical treatment of seemingly doomed patients.