Temporary auxiliary liver transplantation from a living donor to an adult recipient with familial amyloid polyneuropathy

• Published in: Transplantation Vol. 73; no. 4; pp. 628 - 630
• Main Authors: IKEGAMI, Toshihiko, KAWASAKI, Seiji, TOKUDA, Takahiko, IKEDA, Shu-Ichi, OHNO, Yasunari, CHISUWA, Hisanao, URATA, Koichi, NAKAZAWA, Yuichi, HASHIKURA, Yasuhiko, TERADA, Masaru, MIYAGAWA, Shinichi, TAKEI, Yo-Ichi
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott 27-02-2002
• Subjects: Adult; Amyloid Neuropathies, Familial - pathology; Amyloid Neuropathies, Familial - surgery; Biological and medical sciences; Family; Female; Hepatectomy - methods; Humans; Liver - anatomy & histology; Liver Transplantation - methods; Liver, biliary tract, pancreas, portal circulation, spleen; Living Donors; Medical sciences; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Tissue and Organ Harvesting - methods; Graft(material); Left; Resection; Liver; Size; Right; Homotransplantation; Polyneuropathy; Atrophy; Compensatory hypertrophy; Partial; Surgery; Graft; Adult; Amyloid; Peripheral nerve disease; Human; Postoperative; Nervous system diseases; Radiodiagnosis; Living donor; Recipient; Temporary; Treatment; Volume; Auxiliary transplantation; Medical imagery; Computerized axial tomography; Portal vein
• ISSN: 0041-1337; 1534-6080
• DOI: 10.1097/00007890-200202270-00027

A 33-year-old patient with familial amyloid polyneuropathy (FAP) underwent temporary auxiliary partial orthotopic liver transplantation (APOLT) from a living donor with a small-for-size graft. The auxiliary left lobar graft, which weighed only 230 g, was orthotopically transplanted after resection of the recipient's left lobe. The right portal vein was transected to induce compensatory hypertrophy of the left lobar graft. Posttransplant computed tomography showed atrophy of the native liver and hypertrophy of the graft, the volume of which had increased to 446 ml by postoperative day 41. The remnant native liver was removed 6 weeks after APOLT, and there were no signs of liver dysfunction during the postoperative course. Our experience with this case suggests that temporary APOLT is the treatment of choice, guaranteeing a sufficient margin of safety for both donor and recipient, in living donor liver transplants for FAP where the donor's left lobe is disproportionately small.