Recently, Prof. Wang Wentao’s team in West China Hospital’s Department of Hepatic Surgery completed the 100th case of ex vivo liver resection and auto-transplantation (ERAT) in treating end-stage complicated hepatic alveolar echinococcosis (HAE). According to literature retrieval, Prof. Wang Wentao’s team currently ranks the top first globally in the number of cases completed, with the relevant indicators of surgical safety and prognosis reaching the world’s leading level.

At present, the ERAT technique has become a characteristic therapy for end-stage complicated HAE in WCH’s Department of Hepatic Surgery. A total of 100 cases have been completed, with a success rate of 100%. In the median follow-up period of 49 months, a perioperative survival rate of 95% and a long-term survival rate of 93% have been found. The application of ERAT has promoted liver surgery technique development and received extensive attention from the medical community and national institutions.

ERAT is primarily used to remove some sophisticated liver tumors beyond the reach of conventional hepatectomy, such as hepatocellular carcinoma or hilar cholangiocarcinoma that invades inferior vena cava or hepato-caval confluence. The operation includes three major steps: 1. dissection and procurement of the impaired liver; 2.ex vivo hepatectomy combined with individualized conduits repairing procedures; 3. residual liver replantation and conduits reconstruction. Such technologies as living donor liver transplantation, split liver transplantation, in situ hypothermic perfusion and hemodynamics maintenance are used to avoid the risk of bleeding during the complex hepatectomy and liver ischemia caused by vascular occlusion. ERAT technology involves many cutting-edge surgical technologies that only a few medical centers and teams in the world have the ability to carry out such “highly complicated liver surgical technologies.”

Since 2014, Wang’s team devoted to exploring the clinical practice of ERAT technology, creatively taking borderline tumors and other benign liver tumors, such as end-stage complicated HAE, as the surgical indications for ERAT. Compared with the traditional liver allotransplantation, ERAT requires neither an organ donor nor any postoperative immunosuppressant, thus significantly reducing the postoperative recurrence and cutting the treatment cost by more than 60%. For the cases that meet the treatment criteria, ERAT undoubtedly has more advantages in terms of both clinical efficacy and health economics.