AUXILIARY LIVER-TRANSPLANTATION WITH ARTERIALIZATION OF THE PORTAL-VEIN FOR ACUTE HEPATIC-FAILURE

Six adult patients suffering from acute hepatic failure and with a hig h urgent status underwent heterotopic auxiliary liver transplantation. In four of these patients, the portal vein of the liver graft was art erialized in order to leave the native liver and the liver hilum untou ched and to be able to place the liver graft wherever space was availa ble in the abdomen. The arterial blood flow via the portal vein was ta pered by the width of the anastomosis. Two patients died! one of sepsi s on postoperative day 17 (POD), the other after 3 months due to a sev ere CMV pneumonia. There were no technically related deaths. The nativ e liver showed early regeneration in all cases. In one patient, the au xiliary graft was removed 6 weeks after transplantation. Four weeks la ter, he had to undergo orthotopic retransplantation due to a recurrent fulminant failure of the recovered native liver. This patient is aliv e more than 1 year after the operation. We conclude that heterotopic a uxiliary liver transplantation with portal vein arterialization is a s uitable approach to bridging the recovery of the acute failing native liver.