TEMPORARY HETEROTOPIC AUXILIARY LIVER-TRANSPLANTATION FOR FULMINANT-HEPATITIS-B

Background/Aims: Orthotopic liver transplantation has been shown to im prove survival in fulminant hepatic failure. However, after orthotopic liver transplantation life-long immunosuppression is necessary and gr aft complications may occur. Methods: We employed heterotopic auxiliar y liver transplantation in a 26-year-old man with fulminant hepatic fa ilure due to hepatitis B virus infection. Results: From a comatose sta te with seizures and decerebrate posturing, the patient woke up the da y after heterotopic auxiliary liver transplantation. The graft functio ned sufficiently. After 2 weeks, when peritonitis developed, immunosup pression was stopped since the native liver was recovering as shown by serial HIDA scans, liver biopsies, clotting parameters and serum bili rubin. When severe rejection of the graft developed 2 weeks later, and the peritonitis had been treated successfully, the native liver had r ecovered sufficiently to allow the graft to be removed. Now more than 1 year after heterotopic auxiliary liver transplantation, the patient is free from medication and he is immune for hepatitis B virus, his li ver tests have returned to normal and he has regained his normal life. Conclusions: Temporary heterotopic auxiliary liver transplantation fo r fulminant hepatitis B is feasible.