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. 2018 Dec;26(1):54-58.
doi: 10.1159/000487155. Epub 2018 Mar 7.

Auxiliary Liver Transplantation as a Transient Treatment for Acute Liver Failure: Two Cases

David N Perdigoto  1 , Luís Tomé  1   2 , Dulce Diogo  2 , José Ferrão  2 , Ricardo Martins  2 , Pedro Oliveira  2 , Guilherme Tralhão  2   3 , Emanuel Furtado  2
Affiliations

Auxiliary Liver Transplantation as a Transient Treatment for Acute Liver Failure: Two Cases

David N Perdigoto et al. GE Port J Gastroenterol. 2018 Dec.

Abstract
in English, Portuguese

Introduction: Acute liver failure is an uncommon condition associated with a high mortality. Most patients do not survive without liver transplantation. In the last decades, auxiliary liver transplantation has emerged as a therapeutic option.

Clinical case: The authors present two cases of acute liver failure that required liver transplantation. Given the patients' young age and the preserved macroscopic liver pattern evaluated in surgery, auxiliary liver transplantation was executed using different surgical approaches. Afterwards, following confirmed full native liver regeneration, the patients were submitted to auxiliary liver hepatectomy, which was accomplished without complications.

Conclusion: Auxiliary liver transplantation can be regarded as an effective temporary treatment for acute liver failure in selected cases, allowing an immunosuppression-free life.

Introdução: A falência hepática aguda é uma entidade clínica pouco comum, mas associada a elevada mortalidade. A maioria dos doentes não sobreviverá sem transplante hepático. Nas últimas décadas, o transplante hepático auxiliar tem sido utilizado como uma opção terapêutica valorizável.

Caso clínico: Apresentam-se dois casos de falência hepática aguda tratados com transplante hepático. Tendo em conta a idade jovem dos doentes e a noção de preservação macroscópica do fígado, recorreu-se à opção de transplante hepático auxiliar utilizando técnicas diferentes. Posteriormente, após confirmação de regeneração hepática completa, procedeu-se à hepatectomia do fígado auxiliar.

Conclusão: O transplante hepático auxiliar constitui uma terapêutica transitória eficaz em alguns casos de falência hepática aguda, permitindo um futuro isento de imunossupressão.

Keywords: Acute liver failure; Auxiliary liver transplantation; Immunosuppression; Liver transplantation.

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Figures

Fig. 1.
Fig. 1.
Heterotopic auxiliary liver transplantation with placement of a complete liver implant in the right flank.
Fig. 2.
Fig. 2.
Abdominal magnetic resonance imaging before (a) and after the heterotopic auxiliary liver transplantation (b).
Fig. 3.
Fig. 3.
Native and auxiliary liver function assessed by 99mTc-labelled hepatobiliary iminodiacetic acid scintigraphy performed 3 days (a), 9 days (b), and 1 month (c) after the heterotopic auxiliary liver transplantation.
Fig. 4.
Fig. 4.
Auxiliary liver transplantation (CT images) using the REPALT (reno-portal auxiliary liver transplantation) technique. a Before transplantation. b After transplantation. c After auxiliary liver hepatectomy.
See this image and copyright information in PMC

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