| Abstract: | Heterotopic liver transplantation utilizing intraportal hyperalimentation was studied in dog for the purpose of temporary hepatic support for acute liver failure. The liver graft was transplanted in the right lower abdomen of the recipient, and its suprahepatic IVC was anastomosed end-to-side to the infra-renal IVC of the recipient. The celiac artery of the graft was anastomosed end-to-end to the right internal iliac artery of the recipient. An infusion catheter was placed in the donor's portae and intraportal hyperalimentation with insulin was performed. A polyethylene tube (1.7 mm bore) was inserted into the CBD of the graft and led through the body wall as an external biliary drain, after which the recipient's CBD was ligated and transected. The grafts functioned well and excreted bile for 6 days in a non-immunosuppressed group and until death in an immunosuppressed group. Serum bilirubin levels of the recipients increased slightly or were within normal range. At autopsy, the grafts showed no atrophy. Heterotopic liver transplantation with intraportal hyperalimentation will be useful as a temporary hepatic support for acute liver failure in the future. |
