Auxiliary liver transplant in fulminant failure.
Fulminant hepatic failure (FHF) is defined as a syndrome of acute liver failure with the development of hepatic encephalopathy and severe hypoprothrombinemia occurring within 2 months of the onset of symptoms or jaundice in a person without preexisting liver disease. Total orthotopic liver transplantation (OLTX) is a lifesaving therapeutic option for patients with FHF, but currently requires lifelong immunosuppression to maintain the graft. Auxiliary partial orthotopic liver transplantation (A-OLTX) is a procedure whereby only a portion of the native liver is removed, and the remainder of the native liver is left in situ. A-OLTX provides temporary support until the native liver recovers and immunosuppression can be withdrawn. We describe the successful application of emergency A-OLTX in a young girl who accidentally ingested Amanita phalloides mushrooms and developed FHF.
Rosenthal
P
P
Pediatric Liver Transplant Program University of California, San Francisco Medical Center, San Francisco, CA 94143, USA.
Roberts
J P
JP
Ascher
N L
NL
Emond
J C
JC
D000293:Adolescent; D005260:Female; D006501:Hepatic Encephalopathy / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008099:Liver / Q000473:pathology; D008115:Liver Regeneration; D016031:Liver Transplantation / Q000379:methods*; D009145:Mushroom Poisoning / Q000150:complications