Emergency Subtotal Hepatectomy: A New Concept for Acetaminophen-Induced Acute Liver Failure: Temporary Hepatic Support by Auxiliary Orthotopic Liver Transplantation Enables Long-term Success

@article{Lodge2008EmergencySH,
  title={Emergency Subtotal Hepatectomy: A New Concept for Acetaminophen-Induced Acute Liver Failure: Temporary Hepatic Support by Auxiliary Orthotopic Liver Transplantation Enables Long-term Success},
  author={J. Peter A. Lodge and Dowmitra Dasgupta and K. Rajendra Prasad and Magdy S. Attia and Giles J. Toogood and Mervyn H. Davies and Charles Millson and Niall P Breslin and Judith I. Wyatt and Philip Robinson and Mark C Bellamy and Nicola J. Snook and Stephen G. Pollard},
  journal={Annals of Surgery},
  year={2008},
  volume={247},
  pages={238-249}
}
Introduction:Acetaminophen (paracetamol) overdose (AOD) has recently emerged as the leading cause of acute liver failure (ALF) in the United States, with an incidence approaching that seen in the United Kingdom. We describe a new way to treat AOD ALF patients fulfilling King's College criteria for “super-urgent” liver transplantation. Methods:Beginning in June 1998, we have been piloting a clinical program of subtotal hepatectomy and auxiliary orthotopic liver transplantation (ALT) for AOD ALF… 

Subtotal hepatectomy and whole graft auxiliary transplantation for acetaminophen-associated acute liver failure.

TLDR
Although OLT remains standard practice for AOD-induced ALF, life-long immunosuppression is required, a favourable survival rate using a subtotal hepatectomy and WGALT has been demonstrated, and importantly, all successful patients have undergone complete immunosupression withdrawal.

Complete spontaneous liver graft disappearance after auxiliary liver transplantation

TLDR
Signs of hypertrophy of the native liver were observed and was confirmed by liver biopsy, which showed marked native liver regeneration with no acute or chronic inflammation, and immunosuppressive treatment was stopped completely 18 months after AOLT.

Simplified technique for auxiliary orthotopic liver transplantation using a whole graft

TLDR
The procedure improved liver function and decreased intracranial hypertension in the postoperative period and is the first case of auxiliary orthotopic liver transplantation in Brazil.

Auxiliary liver transplantation in children

TLDR
Auxiliary liver transplants should be considered for the treatment of children with acute liver failure satisfying current criteria for liver transplantation.

The use of temporary portocaval shunt as a technical aid in auxiliary orthotopic liver transplantation

  • M. CortésH. Vilca‐MelendezN. Heaton
  • Medicine
    Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
  • 2016
Auxiliary orthotopic liver transplantation (AOLT) is an accepted treatment option for patients under 40 years old with acute liver failure (ALF) consisting of the implantation of a partial or whole

Current status of auxiliary partial orthotopic liver transplantation for acute liver failure

  • M. RelaI. KaliamoorthyM. Reddy
  • Medicine
    Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
  • 2016
TLDR
Results of this procedure have continued to improve with improving surgical techniques and a better understanding of the natural history of acute liver failure (ALF) and liver regeneration.

Technique of hepatic arterial anastomosis in living donor pediatric auxiliary partial orthotopic liver transplantation

  • M. Rela
  • Medicine
    Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
  • 2013
TLDR
This work describes an alternative technique for arterial revascularization of a left lateral section auxiliary liver graft in a child who underwent APOLT for acute liver failure and was able to overcome a size mismatch problem between donor and recipient arteries.

Right Hepatic Trisectionectomy for Hepatobiliary Diseases: Results and an Appraisal of Its Current Role

TLDR
Age over 70 years, preoperative bilirubin levels, and the development of postoperative renal failure were found to be independent predictors of long-term survival and right hepatic trisectionectomy remains a challenging procedure.

Postoperative issues and outcome for acute liver failure

  • J. O'grady
  • Medicine
    Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
  • 2008
TLDR
Outcomes after liver transplantation are poorer than those for elective transplantation but superior to those found for comparably ill patients being transplanted for chronic liver disease.

References

SHOWING 1-10 OF 38 REFERENCES

Auxiliary partial orthotopic liver transplantation (APOLT) for fulminant hepatic failure: First successful case report

TLDR
The APOLT procedure indicates a new way in the treatment of fulminant hepatic failure and combines the advantages of auxiliary grafting with the disadvantages of an orthotopic normal position of the graft, thus facilitating timely decision making for indication.

Auxiliary Partial Orthotopic Versus Standard Orthotopic Whole Liver Transplantation for Acute Liver Failure: A Reappraisal From a Single Center by a Case-Control Study

TLDR
This analysis suggests that the indications for an APOLT procedure should be reconsidered in the light of the risks of technical complications and neurologic sequelae, and using optimal grafts,APOLT and OLT have similar patient survival rates, however, the complication rate is higher with AP OLT.

Total Hepatectomy and Liver Transplantation as Two‐stage Procedure

TLDR
Two-stage total hepatectomy with temporary portocaval shunt, and subsequent liver transplantation can be a life-saving approach in patients most likely to die of the sequelae of advanced liver or graft necrosis or exsanguination that cannot be controlled by conventional treatment or immediate liver transplation.

Auxiliary partial orthotopic liver transplantation for acute liver failure.

Auxiliary liver transplantation for acute liver failure.

TLDR
In selected patients aged <40 years without haemodynamic instability, the use of ABO-compatible, non-steatotic grafts harvested from young donors with normal liver function can restore liver function and prevent the occurrence of irreversible brain damage.

Use and outcome of liver transplantation in acetaminophen‐induced acute liver failure

TLDR
Liver transplantation is an effective treatment in a relatively small number of patients with acetaminophen‐induced hepatotoxicity, and for a substantial proportion of patients, transplantation was never an option because of the rapidity of clinical deterioration.

Auxiliary liver transplantation for fulminant hepatitis B: Results from a series of six patients with special emphasis on regeneration and recurrence of hepatitis B

  • F. DurandJ. Belghiti D. Valla
  • Medicine, Biology
    Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
  • 2002
TLDR
The results suggest that the use of an auxiliary graft is a safe alternative in selected patients with fulminant hepatitis B, and regeneration of the native liver seems to occur in most cases, allowing discontinuation of immunosuppression, which is a major advantage over conventional transplantation.

[Auxiliary heterotopic liver transplantation].

  • O. Terpstra
  • Medicine
    Nederlands tijdschrift voor geneeskunde
  • 1991
TLDR
The magnitude of the surgical procedure of orthotopic liver transplantation restricts its use to patients who are in relatively stable condition with regard to synthesis of clotting factors as well as cardiopulmonary and nutritional status.

Auxiliary Liver Transplantation and Bioartificial BridgingProcedures in Treatment of Acute Liver Failure

TLDR
It is concluded that liver failure should no longer be handled outside centers where all types of transplantation can be offered, and where innovative therapies such as hepatocyte transplantation and extracorporeal liver-assist devices are being developed and evaluated.