{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T05:05:37Z","timestamp":1773378337541,"version":"3.50.1"},"reference-count":6,"publisher":"Springer Science and Business Media LLC","issue":"12","license":[{"start":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T00:00:00Z","timestamp":1756252800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T00:00:00Z","timestamp":1756252800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Ann Surg Oncol"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Leiomyosarcomas of the inferior vena cava (IVC) pose significant surgical challenges, particularly when tumors extend to the hepatic veins (HVs) and the heart. Such cases often necessitate innovative surgical strategies involving complex vascular and organ reconstruction.<jats:sup>1\u20136<\/jats:sup>\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Patient and Methods<\/jats:title>\n            <jats:p>The patient is a 61-year-old female with a large expansile IVC leiomyosarcoma extending into the right atrium and involving the atrial septum. Imaging revealed complete occlusion of the IVC and all major HVs.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The tumor was resected en bloc, along with the whole liver, IVC, and portions of both atria under cardiopulmonary and portosystemic bypass. The atria and septum were reconstructed with bovine pericardial patches. The vena cava was reconstructed with a ringed Gore-Tex graft. Simultaneously at the back table, tumor resection and HV thrombectomy were performed. The hepatic vein outflow was reconstructed with a bovine pericardial patch. The tumor-free liver was then reimplanted. Operative time was 13 h 11 min, with an estimated blood loss of 4 L. The patient was then discharged home 1 month later. After 9 months, two small recurrent liver lesions were identified and addressed with partial liver resection following chemotherapy. The patient was alive and disease-free 16 months after initial surgery.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>This case highlights the successful use of ex vivo surgery and liver autotransplantation in managing an extensive IVC leiomyosarcoma. This innovative approach, combined with open heart surgery, achieved complete tumor resection with a reasonable postoperative recovery and oncologic outcome.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1245\/s10434-025-17868-8","type":"journal-article","created":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T19:27:15Z","timestamp":1756322835000},"page":"9156-9157","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A Surgical Video of an Ex Vivo Liver Resection with Autotransplantation in a Case with Extensive Inferior Vena Cava Leiomyosarcoma Extending to the Right Atrium with Atrial Septal Involvement and Complete Occlusion of All Major Hepatic Veins"],"prefix":"10.1245","volume":"32","author":[{"given":"Junichi","family":"Yoshikawa","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Liou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroo","family":"Takayama","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason","family":"Hawksworth","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoaki","family":"Kato","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,8,27]]},"reference":[{"issue":"5","key":"17868_CR1","doi-asserted-by":"publisher","first-page":"766","DOI":"10.1097\/SLA.0000000000004270","volume":"272","author":"T Kato","year":"2020","unstructured":"Kato T, Hwang R, Liou P, et al. Ex vivo resection and autotransplantation for conventionally unresectable tumors - an 11-year single center experience. Ann Surg. 2020;272(5):766\u201372. https:\/\/doi.org\/10.1097\/SLA.0000000000004270.","journal-title":"Ann Surg."},{"issue":"5","key":"17868_CR2","doi-asserted-by":"publisher","first-page":"854","DOI":"10.1097\/SLA.0000000000005640","volume":"276","author":"J Weiner","year":"2022","unstructured":"Weiner J, Hemming A, Levi D, et al. Ex vivo liver resection and autotransplantation: should it be used more frequently? Ann Surg. 2022;276(5):854\u20139. https:\/\/doi.org\/10.1097\/SLA.0000000000005640.","journal-title":"Ann Surg."},{"issue":"3","key":"17868_CR3","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1002\/(sici)1096-9098","volume":"65","author":"MN Kulaylat","year":"1997","unstructured":"Kulaylat MN, Karakousis CP, Doerr RJ, Karamanoukian HL, O\u2019Brien J, Peer R. Leiomyosarcoma of the inferior vena cava: a clinicopathologic review and report of three cases. J Surg Oncol. 1997;65(3):205\u201317. https:\/\/doi.org\/10.1002\/(sici)1096-9098.","journal-title":"J Surg Oncol."},{"issue":"2","key":"17868_CR4","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1097\/01.sla.0000229964.71743.db","volume":"244","author":"E Kieffer","year":"2006","unstructured":"Kieffer E, Alaoui M, Piette JC, Cacoub P, Chiche L. Leiomyosarcoma of the inferior vena cava: experience in 22 cases. Ann Surg. 2006;244(2):289\u201395. https:\/\/doi.org\/10.1097\/01.sla.0000229964.71743.db.","journal-title":"Ann Surg."},{"key":"17868_CR5","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2021.690617","volume":"11","author":"T Tuxun","year":"2021","unstructured":"Tuxun T, Li T, Apaer S, et al. Ex vivo liver resection and autotransplantation as surgical option for zone II-III leiomyosarcoma of IVC: a case report and literature review. Front Oncol. 2021;11:690617. https:\/\/doi.org\/10.3389\/fonc.2021.690617.","journal-title":"Front Oncol."},{"key":"17868_CR6","doi-asserted-by":"publisher","unstructured":"Lotze U, Reponova J, Muth G, et al. Leiomyosarcoma of the inferior vena cava extending into the right atrium. A rare differential diagnosis of a right atrial tumor with fatal outcome.\u00a0Herz. 2012;37(5):573-578. https:\/\/doi.org\/10.1007\/s00059-011-3580-y","DOI":"10.1007\/s00059-011-3580-y"}],"container-title":["Annals of Surgical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1245\/s10434-025-17868-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1245\/s10434-025-17868-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1245\/s10434-025-17868-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T15:41:06Z","timestamp":1760715666000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1245\/s10434-025-17868-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,27]]},"references-count":6,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["17868"],"URL":"https:\/\/doi.org\/10.1245\/s10434-025-17868-8","relation":{},"ISSN":["1068-9265","1534-4681"],"issn-type":[{"value":"1068-9265","type":"print"},{"value":"1534-4681","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,27]]},"assertion":[{"value":"7 April 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 July 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 August 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Jason Hawksworth, Intuitive Surgical\u2013proctoring. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosure"}}]}}