HETEROTOPIC AUXILIARY LIVER-TRANSPLANTATION IN A 3-YEAR-OLD BOY WITH ACUTE LIVER-FAILURE AND APLASTIC-ANEMIA

Background. Auxiliary liver transplantation offers an alternative meth od to conventional transplantation in acute liver failure. It is espec ially challenging for children because lifelong immunosuppression may be avoided. However, experience with this procedure is rare and there is controversy about whether to place the graft orthotopically or hete rotopically. Methods. We present the case of a 3-year-old boy with acu te liver failure due to non-ABC hepatitis complicated by aplastic anem ia who underwent auxiliary liver transplantation. Segments 2 and 3 of the graft were implanted heterotopically in the right lower abdomen. R esults. Good liver function was immediately restored. Aplastic anemia resolved 3 weeks after transplantation. Immunosuppressive therapy was discontinued after 14 months, and the graft was left to atrophy. Thirt y-nine months after transplantation the boy is alive and well with nor mal liver function tests and normal blood cell counts. Conclusions. He terotopic auxiliary liver transplantation allowed recovery of the nati ve liver in a child with acute liver failure and aplastic anemia due t o non-ABC hepatitis.