title: Left Lobe Auxiliary Liver Transplantation for End-stage Hepatitis B Liver Cirrhosis.
abstract: Auxiliary liver transplantation (ALT) for hepatitis B virus (HBV)-related liver cirrhosis previously showed poor results, because the native liver was a significant source of HBV recurrence and the graft could be rapidly destroyed by HBV infection in an immunosuppressive condition. Four patients with HBV-related liver cirrhosis were unable to undergo orthotopic liver transplantation because the only available grafts of left lobe were too small. Under entecavir-based anti-HBV treatment, they underwent ALT in which the recipient left liver was removed and the small left lobe graft was implanted in the corresponding space. The mean graft weight/recipient weight was 0.49% (range, 0.38%-0.55%). One year after transplantation, the graft sizes were increased to 273% and the remnant livers were decreased to 44%. Serum HBV DNA was persistently undetectable. Periodic graft biopsy showed no signs of tissue injury and negative immunostaining for hepatitis B surface antigen and hepatitis B core antigen. After a mean follow-up period of 21 months, all patients live well with normal graft function. Our study suggests that ALT for HBV-related liver cirrhosis is feasible under entecavir-based anti-HBV treatment. Successful application of small left livers in end-stage liver cirrhosis may significantly increase the pool of left liver grafts for adult patients.
authors.affiliation: Institute of Organ Transplantation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.|Ministry of Health, Key Laboratory of Organ Transplantation, Wuhan, China.|Ministry of Education, Key Laboratory of Organ Transplantation, Wuhan, China.
authors.forename: S-F
authors.initials: SF
authors.lastname: Wang
authors.affiliation: Institute of Organ Transplantation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.|Ministry of Health, Key Laboratory of Organ Transplantation, Wuhan, China.|Ministry of Education, Key Laboratory of Organ Transplantation, Wuhan, China.
authors.forename: X-P
authors.initials: XP
authors.lastname: Chen
authors.affiliation: Institute of Organ Transplantation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.|Ministry of Health, Key Laboratory of Organ Transplantation, Wuhan, China.|Ministry of Education, Key Laboratory of Organ Transplantation, Wuhan, China.
authors.forename: Z-S
authors.initials: ZS
authors.lastname: Chen
authors.affiliation: Institute of Organ Transplantation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: L
authors.initials: L
authors.lastname: Wei
authors.affiliation: Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: S-L
authors.initials: SL
authors.lastname: Dong
authors.affiliation: Institute of Organ Transplantation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.|Ministry of Health, Key Laboratory of Organ Transplantation, Wuhan, China.|Ministry of Education, Key Laboratory of Organ Transplantation, Wuhan, China.
authors.forename: H
authors.initials: H
authors.lastname: Guo
authors.affiliation: Institute of Organ Transplantation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: J-P
authors.initials: JP
authors.lastname: Jiang
authors.affiliation: Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: W-H
authors.initials: WH
authors.lastname: Teng
authors.affiliation: Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Z-Y
authors.initials: ZY
authors.lastname: Huang
authors.affiliation: Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: W-G
authors.initials: WG
authors.lastname: Zhang
mesh_terms: D000328:Adult; D001706:Biopsy; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006509:Hepatitis B / Q000150:complications* / Q000821:virology; D006515:Hepatitis B virus / Q000302:isolation & purification*; D006801:Humans; D008103:Liver Cirrhosis / Q000209:etiology / Q000601:surgery*; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors
keywords: clinical research/practice; liver transplantation/hepatology; liver transplantation: auxiliary; liver transplantation: living donor; liver transplantation: split