title: Auxiliary liver transplantation: a form of gene therapy in selective metabolic disorders.
abstract: Auxiliary liver transplantation is an accepted form of therapy in acute liver failure and in certain metabolic disorders. We report India's first successful auxiliary liver transplantation for Crigler-Najjar syndrome type 1, showing that it is technically feasible and safe procedure. It is utmost important to select appropriate cases for auxiliary transplant for successful long-term outcome. The surgeon should also have an understanding of the portal flow dynamics, as steal phenomenon can occur, depriving blood blow to either graft or native liver. Though successful in animal models, gene therapy is still in experimental stage in humans and pace of progress has been disappointing. Auxiliary liver transplantation retains the native liver for future gene therapy. These children are young and are likely to have a long life expectancy, and withdrawal of immunosuppression would be a huge advantage.
authors.affiliation: Institute of Liver Disease and Transplantation, Global Hospitals and Health City, Chennai, Tamil Nadu, India.
authors.forename: Naresh P
authors.initials: NP
authors.lastname: Shanmugam
authors.affiliation: Institute of Liver Disease and Transplantation, Global Hospitals and Health City, Chennai, Tamil Nadu, India.
authors.forename: Rajasekhar
authors.initials: R
authors.lastname: Perumalla
authors.affiliation: Institute of Liver Disease and Transplantation, Global Hospitals and Health City, Chennai, Tamil Nadu, India.
authors.forename: Rg
authors.initials: R
authors.lastname: Gopinath
authors.affiliation: Institute of Liver Disease and Transplantation, Global Hospitals and Health City, Chennai, Tamil Nadu, India.
authors.forename: A
authors.initials: A
authors.lastname: Olithselvan
authors.affiliation: Institute of Liver Disease and Transplantation, Global Hospitals and Health City, Chennai, Tamil Nadu, India.
authors.forename: Joy
authors.initials: J
authors.lastname: Varghese
authors.affiliation: Institute of Liver Disease and Transplantation, Global Hospitals and Health City, Chennai, Tamil Nadu, India.
authors.forename: Dharmesh
authors.initials: D
authors.lastname: Kapoor
authors.affiliation: Institute of Liver Disease and Transplantation, Global Hospitals and Health City, Chennai, Tamil Nadu, India.
authors.forename: Mohmed
authors.initials: M
authors.lastname: Rela
keywords: ALF, acute liver failure; APOLT, auxiliary partial orthotopic liver transplants; Acute liver failure; CNS1, Crigler-Najjar syndrome type 1; Crigler-Najjar syndrome; auxiliary liver transplant; gene therapy; pediatric transplantation