Simplified technique for auxiliary orthotopic liver transplantation using a whole graft

Background

Acute liver failure is associated with a high mortality rate and the main purposesof treatment are to prevent cerebral edema and infections, which often areresponsible for patient death. The orthotopic liver transplantation is the goldstandard treatment and improves the 1-year survival.

Aim

To describe an alternative technique to auxiliary liver transplant on acute liverfailure.

Method

Was performed whole auxiliary liver transplantation as an alternative techniquefor a partial auxiliary liver transplantation using a whole liver graft from achild removing the native right liver performed a right hepatectomy. The patientmet the O´Grady´s criteria and the rational to indicate an auxiliary orthotopicliver transplantation was the acute classification without hemodynamic instabilityor renal failure in a patient with deterioration in consciousness.

Results

The procedure improved liver function and decreased intracranial hypertension inthe postoperative period.

Conclusion

This technique can overcome some postoperative complications that are associatedwith partial grafts. As far as is known, this is the first case of auxiliaryorthotopic liver transplantation in Brazil.