The distortion of the intrahepatic vasculature and biliary system
by cysts is a potential source of complications and accurate definition of these structures preoperatively remains difficult, even with current imaging modalities. Moreover, with the unusual large size of the polycystic liver, the liver is rigid and limits its mobility. Although the hilar vessels are easily accessed, the hepatic veins are particularly difficult to access. These factors increase the risk of a venous bleed or bile leakage. Another drawback of Roxadustat supplier hepatic resection is the risk of subsequent adhesions, which may complicate future liver transplantation. We found 26 articles on 337 PLD patients. Morbidity occurred in 51% of patients and included ascites, pleural effusion, biliary leakage, and hemorrhage. Morbidity was higher in patients who underwent previous surgery or who were on immunosuppressive drugs. Mortality was 3%,
and causes of death were intracerebral hemorrhage, septic shock, and Budd-Chiari syndrome. Mean hospital stay was about 10-15 days. Reoperation was performed because of persistent bleeding, thrombosis, or biliary leakage. The complication rate depended on experience and was lower in high-volume centers. Symptom relief was achieved in 86%. Cyst recurrence was seen in 34% of all patients (Supporting Information Table 3). However, the immediate improvement in patients after the postoperative period was significant. Liver transplantation beta-catenin inhibitor is the only curative therapeutic option in patients with severe polycystic liver.3 next Transplantation is indicated in those patients with extremely disabling symptoms that lead to a seriously decreased quality of life. In addition, untreatable complications, such as portal hypertension and nutritional compromise, are indications for liver transplantation. Liver transplantation
as a therapeutic option should be weighed carefully in view of the shortage of liver donors, the fact that PLD is not associated with excess liver-related mortality, and that liver synthetic function remains normal even in advanced cases. There were 29 articles on 206 PLD patients. The main indications for transplantation were abdominal pain, distension, fullness, dyspnea, extreme fatigue, and malnutrition. Overall, quality of life was severely impaired and patients were physically and socially disabled by these symptoms. A significant proportion of procedures (42%) were a combined liver and kidney transplant. Morbidity was seen in 83 of all patients (41%), whereas 30-day mortality was 5% and overall mortality 17% (Supporting Information Table 4).