AUXILIARY LIVER-TRANSPLANTATION IN PATIENTS WITH FULMINANT HEPATIC-FAILURE - HEPATOBILIARY SCINTIGRAPHIC FOLLOW-UP

Auxiliary liver transplantation (ALT), retaining in place the liver of the recipient, has been proposed as an alternative to liver replaceme nt in patients with fulminant hepatic failure (FHF). Hepatobiliary sci ntigraphy (HS) has proved a unique tool for the separate assessment of graft and native liver function. Forty-eight HS scans were performed, following the injection of technetium-99m trimethyl-bromo-imino-diace tic acid, in six patients who underwent ALT for FHF. Quantitative para meters were derived from the time-activity curves of both the graft an d the native liver. The function of the graft remained normal as long as the patients remained under immunosuppressive therapy (IST). The fu nction of the native liver was almost completely absent in the 1st mon th in five patients, but it improved gradually in four of them. IST wa s then decreased in four patients and finally withdrawn in three. Spon taneous graft atrophy occurred in two patients and the graft was remov ed in two. All of the patients in whom IST was reduced had a normal gl obal hepatic function and selective uptake (RU) >30% at that time. In ALT patients with FHF, HS can distinguish non-invasively the functiona l performance of both the donor and the recipient Liver and its evolut ion with time.