Routine Use of Auxiliary Partial Orthotopic Liver Transplantation for Children With Fulminant Hepatic Failure

Preliminary Report

T. Kato, G. Selvaggi, D. Levi, E. Hernandez, H. Takahashi, M. Velasco, J. Moon, S. Nishida, John F. Thompson, P. Ruiz, G. Sfakianakis, A. Tzakis

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Auxiliary partial orthotopic liver transplantation (APOLT) has been performed for both metabolic disorders and fulminant liver failure (FHF). When the native liver regenerates, the patients with FHF who undergo APOLT have a chance to withdraw immunosuppression. It may be most beneficial for children. This preliminary report describes our start to routinely offer APOLT as an option to standard OLT for children with FHF in 2005. Six children (ages 8 months to 8 years) received APOLT: 1 in 1996 and the others in 2005 and 2006. The donor ages ranged from 4 to 40 years. We used either a left lateral segment or a left lobe graft. The recipient left lobe, which was removed, showed submassive to massive necrosis at the time of transplantation. All children are alive and well. The first patient who received APOLT in 1996 is currently off immunosuppression with a fully recovered native liver; the grafted liver underwent complete atrophy. The 5 remaining subjects are receiving reduced levels of immunosuppression with close monitoring. Their serial liver biopsy specimens show slight to significant recovery. One developed hepatic artery thrombosis, requiring retransplantation. The native liver was retained at the time of retransplantation (redo APOLT). Other postoperative complications included a bile leak (n = 1), invasive mucomycosis of the arm (preexisting condition; n = 1), biliary stricture (n = 1), and acute cellular rejection (n = 3). Posttransplantation length of stay was 6 to 60 days (median, 15 days). In conclusion, APOLT can be safely performed in children with FHF displaying short-term outcomes comparable to standard transplantations.

Original languageEnglish (US)
Pages (from-to)3607-3608
Number of pages2
JournalTransplantation Proceedings
Volume38
Issue number10
DOIs
StatePublished - Dec 2006
Externally publishedYes

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Acute Liver Failure
Liver Transplantation
Liver
Immunosuppression
Transplantation
Preexisting Condition Coverage
Hepatic Artery
Bile
Atrophy
Length of Stay
Pathologic Constriction
Thrombosis
Arm
Necrosis
Tissue Donors
Transplants
Biopsy

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

Routine Use of Auxiliary Partial Orthotopic Liver Transplantation for Children With Fulminant Hepatic Failure : Preliminary Report. / Kato, T.; Selvaggi, G.; Levi, D.; Hernandez, E.; Takahashi, H.; Velasco, M.; Moon, J.; Nishida, S.; Thompson, John F.; Ruiz, P.; Sfakianakis, G.; Tzakis, A.

In: Transplantation Proceedings, Vol. 38, No. 10, 12.2006, p. 3607-3608.

Research output: Contribution to journalArticle

Kato, T, Selvaggi, G, Levi, D, Hernandez, E, Takahashi, H, Velasco, M, Moon, J, Nishida, S, Thompson, JF, Ruiz, P, Sfakianakis, G & Tzakis, A 2006, 'Routine Use of Auxiliary Partial Orthotopic Liver Transplantation for Children With Fulminant Hepatic Failure: Preliminary Report', Transplantation Proceedings, vol. 38, no. 10, pp. 3607-3608. https://doi.org/10.1016/j.transproceed.2006.10.038
Kato, T. ; Selvaggi, G. ; Levi, D. ; Hernandez, E. ; Takahashi, H. ; Velasco, M. ; Moon, J. ; Nishida, S. ; Thompson, John F. ; Ruiz, P. ; Sfakianakis, G. ; Tzakis, A. / Routine Use of Auxiliary Partial Orthotopic Liver Transplantation for Children With Fulminant Hepatic Failure : Preliminary Report. In: Transplantation Proceedings. 2006 ; Vol. 38, No. 10. pp. 3607-3608.
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