BACKGROUND/AIMS: Fulminant hepatic failure (FHF) is usually fatal without liver transplantation. Auxiliary heterotopic partial liver transplantation (AHPLT) may offer advantages over orthotopic liver transplantation (OLT) or any other heterotopic procedure for the treatment of patients with fulminant liver failure. We studied AHPLT in a severe acute hepatic failure model in pigs. METHODOLOGY: Group A (control: n = 5) underwent portal vein and hepatic artery ligation and side-to-side portocaval shunting. Group B (AHPLT: n = 15) underwent host portal vein and hepatic artery ligation and AHPLT. RESULTS: All of the pigs in group A died within 48 hours from massive liver necrosis. Ten of the 15 pigs (67%) in group B had well-functioning grafts. Five of these ten died between 8 and 17 days postoperatively due to various complications. The remaining five survived for sixty days postoperatively in healthy condition. At the time of sacrifice, four of these five had well-functioning grafts weighing 739 +/- 52 g (mean +/- SEM) and regenerated, but still atrophied, host livers weighing 262 +/- 23 g (p < 0.0002). On the other hand, the one remaining pig had an atrophied graft weighing 310 g and a well-regenerated host liver weighing 470 g, probably due to a late, poorly functioning graft associated with severe rejection. CONCLUSION: AHPLT may result in survival despite host hepatic failure, and the host liver may recover within two months, despite total interruption of blood inflow.

Animals↗

PubMedDate not supplied

Analysis of growth rate of pediatric kidneys transplanted into juveniles or adults.

Estimation of renal length was carried out during radionuclide function studies, in cases of pediatric kidneys transplanted into adolescents or adults. In all 24 cases of single kidney transplants, the kidneys eventually increased in size, but at varying rates. From 5 cases with repeat studies close in time, and shortly after transplantation, an apparent maximal growth rate was estimated. In 3 pairs of dual renal transplants, with both kidneys surviving, marked differences in growth of each member of the pair was noted. The present initial description, of rates of change in size of the transplanted pediatric kidneys, may serve as a baseline from which to sort out the contributions of pre- and post-transplant factors.

Adult↗