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  • Title: Living related heterotopic auxiliary partial liver transplantation for extremely small-for-size graft in fulminant liver failure.
    Author: Sato Y, Yamamoto S, Takeishi T, Kobayashi T, Kato T, Watanabe T, Shimamura T, Ichida T, Hatakeyama K.
    Journal: Hepatogastroenterology; 2003; 50(53):1220-2. PubMed ID: 14571703.
    Abstract:
    Adult living related liver transplantation seeks a balance between donor safety and the need to save the recipient's life. A small-for-size graft is a major obstacle for high-risk patients. We experienced a case of heterotopic auxiliary partial liver transplantation with extremely small-for-size graft for fulminant liver failure. The other reasons why we chose to perform heterotopic auxiliary partial liver transplantation were acute renal failure, subshock state, and a left lobe volume of 24% in the standard liver volume of the donor. Hepatic vein reconstruction was made using an inferior meserteric vein patch graft. Portal vein reconstruction was made using end-to-side anastomosis employing an interposed left external iliac vein. The left hepatic artery of the graft was connected to the distal gastroduodenal artery. The patient was discharged 3 months after transplantation. We would recommend heterotopic auxiliary partial liver transplantation as an optional procedure for patients with severe preoperative conditions or extremely small-for-size graft donors.
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