title: A case report of a completely vanished liver graft after auxiliary partial orthotopic liver transplantation.
abstract: BACKGROUND
  Auxiliary partial orthotopic liver transplantation is an alternative technique for the treatment of patients with fulminant hepatic failure and metabolic liver disease. It provides temporary support of liver function until sufficient regeneration of the native liver. Pediatric patients have a long life expectancy and are best candidates to benefit from the interruption of antirejection treatment.
  
  
  METHODS
  A 4-year-old boy underwent auxiliary partial orthotopic liver transplantation for fulminant hepatic failure using a cadaveric left lateral segment of liver. One year after auxiliary partial orthotopic liver transplantation, the patient's native liver was determined to be completely normal and he was doing well. The patient was then gradually weaned from the immunosuppression over the course of one year. The graft was undetectable on follow-up computerized tomography performed before complete cessation of immunosuppression, leading to the diagnosis of "vanishing graft syndrome".
  
  
  CONCLUSIONS
  Graft atrophy commonly occurs after auxiliary partial orthotopic liver transplantation due to cessation of antirejection therapy. But to our knowledge, complete graft disappearance is a rare occurrence reported in the English literature. Timing for withdrawal of the immunosuppression is an important decision to be made in this technique. Hippokratia 2015; 19 (3): 274-277.
authors.affiliation: Department of Radiology, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA.
authors.forename: U
authors.initials: U
authors.lastname: Teomete
authors.affiliation: Division of Trauma and Acute Care Surgery, Department of Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA.
authors.forename: O
authors.initials: O
authors.lastname: Dandin
authors.affiliation: Division of Liver/GI Transplantation, Department of Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA.
authors.forename: A
authors.initials: A
authors.lastname: Tekin
authors.affiliation: Department of Surgery, Faculty of Medicine, University of Suleyman Demirel, Isparta, Turkey.
authors.forename: M Z
authors.initials: MZ
authors.lastname: Sabuncuoglu
authors.affiliation: Department of Pathology and Labolatory Medicine, University of Miami Leonard M. Miller School of Medicine, Jackson Memorial Hospital, Miami, FL, USA.
authors.forename: J
authors.initials: J
authors.lastname: Chapman
keywords: Liver; immunosuppression; transplantation; vanishing