AUXILIARY HETEROTOPIC PARTIAL LIVER-TRANSPLANTATION IN PIGS WITH ACUTE ISCHEMIC LIVER-FAILURE

Background/Aims: Fulminant hepatic failure (FHF) is usually fatal with out liver transplantation. Auxiliary heterotopic partial liver transpl antation (AHPLT) may offer advantages over orthotopic liver transplant ation (OLT) or any other heterotopic procedure for the treatment of pa tients with fulminant liver failure. We studied AHPLT in a severe acut e hepatic failure model in pigs. Methodology: Group A (control: n=5) u nderwent portal vein and hepatic artery ligation and side-to-side port ocaval shunting. Group B (AHPLT: n=15) underwent host portal vein, and hepatic artery ligation and AHPLT. Results: All of the pigs in group A died within 48 hours from massive liver necrosis. Ten of the 15 pigs (67%) in group B had well-functioning grafts. Five of these ten died between 8 and 17 days postoperatively due to various complications. Th e remaining five survived for sixty days postoperatively in healthy co nditions. At the time of sacrifice, four of these five had well-functi oning grafts weighing 739+/-52g (mean+/-SEM) and regenerated but still atrophied, host livers weighing 262+/-23g (p<0.0002). On the other ha nd, the one remaining pig had an. atrophied graft weighing 310g and a well-regenerated host liver weighing 470g, probably due to a late, poo rly functioning graft associated with severe rejection. Conclusion: AH PLT may result in survival despite host hepatic failure, and the host liver may recover within two months, despite total interruption of blo od inflow.