Auxiliary Partial Orthotopic Liver Transplantation in Fulminant Hepatitis

Abstract

Severe Acute Hepatitis is a disease that causes rapid development of liver failure with coagulopathy and encephalopathy. Due to the irreversibility of this condition, the majority of cases should be treated with liver transplantation. However, it is difficult to obtain liver grafts due to the shortage of cadaveric donors and the need for urgent transplantation. An innovative therapy is being used in these cases: Auxiliary Partial Orthotopic Liver Transplantation. This technique consists of resection of the part affected of the liver and to transplant a partial graft allowing the original liver to recovery and a gradual withdrawal of immunosuppression. Material and Methods: A literature review of articles in the Medline-mesh platform with the terms “fulminant hepatitis”, “acute liver failure”, “liver transplantation” and “auxiliary partial orthotopic liver transplantation” plus governmental and official sites to obtain data of epidemiological studies. Results: This technique was recently described with good patient survival rates and it has not been performed in Brazil. Among the advantages are the suspension of immunosuppressive therapy due to the recovery of the original liver and reducing its side effects, and also posing the option of using grafts from living donors. Conclusion: Auxiliary Partial Orthotopic Liver Transplantation is a feasible treatment as shown in international transplant centers. It must be done by properly trained and skilled teams and it will represent an evolution in the liver transplantation in Brazil.