Native hepatectomy after auxiliary partial orthotopic liver transplantation

Citation
M. Kaibori et al., Native hepatectomy after auxiliary partial orthotopic liver transplantation, TRANSPLAN I, 12(5), 1999, pp. 383-386
Citations number
6
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Surgery
Journal title
TRANSPLANT INTERNATIONAL
ISSN journal
0934-0874 → ACNP
Volume
12
Issue
5
Year of publication
1999
Pages
383 - 386
Database
ISI
SICI code
0934-0874(199910)12:5<383:NHAAPO>2.0.ZU;2-7
Abstract
In countries where a living donor is the only source of the graft, the limi ted size of the graft is of serious concern when considering extending the procedure to adult recipients. In order to overcome this problem, auxiliary partial orthotopic liver transplantation (APOLT) was applied to the concep t that the residual native liver would support the graft function until the graft expanded enough to work by itself. We herein report on a 20-year-old woman with primary sclerosing cholangitis (PSC), who received a small-size liver graft by APOLT. Computed tomography and scintigraphy showed that the graft had regenerated sufficiently 1 month after the operation. The diseas ed residual native liver is potentially carcinogenetic. Therefore, second-s tage native hepatectomy was done 35 days after the first operation. Histopa thologic examination of the resected native liver revealed biliary cirrhosi s with PSC but no evidence of cholangiocarcinoma. Second-stage native hepat ectomy after APOLT seems to be a curative treatment for chronic end-stage l iver disease with graft size mismatch that may be as good as orthotopic liv er transplantation.