Living related heterotopic auxiliary partial liver transplantation for extremely small-for-size graft in fulminant liver failure.
Adult living related liver transplantation seeks a balance between donor safety and the need to save the recipient's life. A small-for-size graft is a major obstacle for high-risk patients. We experienced a case of heterotopic auxiliary partial liver transplantation with extremely small-for-size graft for fulminant liver failure. The other reasons why we chose to perform heterotopic auxiliary partial liver transplantation were acute renal failure, subshock state, and a left lobe volume of 24% in the standard liver volume of the donor. Hepatic vein reconstruction was made using an inferior meserteric vein patch graft. Portal vein reconstruction was made using end-to-side anastomosis employing an interposed left external iliac vein. The left hepatic artery of the graft was connected to the distal gastroduodenal artery. The patient was discharged 3 months after transplantation. We would recommend heterotopic auxiliary partial liver transplantation as an optional procedure for patients with severe preoperative conditions or extremely small-for-size graft donors.
Division of Digestive and General Surgery, Niigata University Graduate School of Medicine and Dental Sciences, 1-757 Asahimachi-dori, Niigata 951-8510, Japan. kanishok@med.niigata-u.ac.jp
Yoshinobu
Y
Sato
Satoshi
S
Yamamoto
Toshiyuki
T
Takeishi
Takashi
T
Kobayashi
Takashi
T
Kato
Takayuki
T
Watanabe
Toshihiko
T
Shimamura
Takafumi
T
Ichida
Katsuyoshi
K
Hatakeyama
D006801:Humans; D008102:Liver Circulation; D017093:Liver Failure / Q000601:surgery*; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D017082:Portal Pressure; D016042:Transplantation, Heterotopic