[Favorable results of auxiliary heterotopic liver transplantation in patients with end-stage chronic liver insufficiency].
Auxiliary heterotopic liver transplantation (HLT), which avoids removal of the host liver, may improve the results of liver transplantation in patients with end-stage chronic liver disease. However, the results of HLT have so far been disappointing. In 1986 a program of HLT was started in the University Hospital Rotterdam-Dijkzigt. Eighteen patients with chronic liver failure underwent HLT. Twelve out of 18 (67%) patients were discharged 25 days after transplantation with normal liver function. Six patients died within 3 months after operation due to septic causes. Three months after transplantation ascites was no longer detectable and oesophageal varices had disappeared in all surviving recipients of HLT. The actuarial 3 and 12 months survival rate was 67%. Hepatitis B virus reinfection was seen in all patients. In two patients cirrhosis of the graft developed within one year. These data suggest that HLT in patients with chronic liver failure gives long-term metabolic support and adequate decompression of portal system, and is associated with a morbidity and mortality comparable to that of orthotopic liver transplantation.
Metselaar
H J
HJ
Afd. Inwendige Geneeskunde, Academisch Ziekenhuis Rotterdam-Dijkzigt.
Hesselink
E J
EJ
Schalm
S W
SW
Terpstra
O T
OT
D000328:Adult; D000714:Anastomosis, Surgical / Q000379:methods; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007430:Intraoperative Care; D008107:Liver Diseases / Q000601:surgery*; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D016042:Transplantation, Heterotopic / Q000379:methods*
D007166:Immunosuppressive Agents
Gunstige resultaten van auxiliaire heterotope levertransplantatie bij patiënten in het eindstadium van chronische leverinsufficiëntie.