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Auxiliary liver transplantation is a unique surgical procedure in which the recipient’s liver is not completely removed. Instead, a portion of a donor’s liver is transplanted while retaining the recipient’s native liver, with the goal of allowing it to regenerate. This procedure is often considered for patients with hereditary or metabolic liver diseases, where there may be potential for gene therapy in the future. Given the liver’s remarkable regenerative capabilities, an auxiliary liver transplant offers hope that immunosuppression can be reduced once the native liver has recovered. This approach is particularly beneficial for young patients experiencing severe acute liver failure.
Alternate Name : Heterotopic Auxiliary Liver Transplant (HALT)
Body Location : Upper right part of the abdomen
Procedure Type : Surgical or laparoscopic
Before undergoing an auxiliary liver transplant, both the donor and recipient will go through several preparation steps to ensure the procedure’s success:
Evaluation : Both the donor and recipient will undergo a thorough medical evaluation, which includes physical exams, blood tests, and other diagnostic procedures to assess their health and identify potential complications.
Counseling : The donor and recipient will be counseled about the procedure, its risks, benefits, and the expected impact on their lives. This helps both parties make informed decisions.
Coordination : The surgical team will work closely with the hospital and medical staff to ensure everything is in place for the procedure. This includes arranging the operating room, scheduling, and post-operative care.
Preparation : Both the donor and recipient will be given instructions to follow in the days leading up to surgery. This may involve changes to diet, medications, and avoiding certain activities.
Auxiliary liver transplantation can be performed in two types: orthotopic and heterotopic. The remnant of the recipient’s liver helps prevent small-for-size syndrome until the graft has fully regenerated and can take over normal liver functions. This procedure is most effective for candidates who meet the following criteria:
Their liver can function in an auxiliary role.
The auxiliary liver transplant offers more benefit than waiting for a larger graft.
The process typically involves the following steps:
Graft removal : A portion of the donor’s liver is surgically removed using laparoscopic techniques.
Recipient liver preparation : The diseased or non-functional part of the recipient’s liver is removed, leaving a healthy portion of the liver intact.
Graft placement : The donor liver graft is then positioned and connected to the recipient’s blood vessels, ensuring proper blood flow.
Bile duct connection: The recipient’s bile ducts are connected to the donated liver to facilitate proper bile drainage.
Incision closure: Once the transplant is complete, the surgical team closes the incisions with sutures or staples.
After the procedure, there are several important follow-up steps to ensure the success of the auxiliary liver transplant:
Liver Monitoring : The transplant team will monitor both parts of the liver to ensure they function correctly. This includes regular blood tests, imaging, and other diagnostic assessments.
Immunosuppressant Medications : To prevent rejection of the transplanted liver, the recipient will need to take immunosuppressant medications, which suppress the immune system’s response. These medications will also be prescribed to the living donor to aid recovery.
Managing Side Effects : Some recipients may experience side effects from the medications or the transplant. The transplant team will assist in managing these to ensure the comfort and safety of both the donor and recipient.
Diet and Lifestyle Management : Both the donor and recipient must follow specific dietary guidelines and lifestyle changes to support recovery and ensure the success of the transplant. Regular exercise and sufficient rest will also be encouraged.
Follow-up Appointments: Regular follow-up visits with the transplant team will be necessary to monitor progress, assess liver function, and address any concerns.
Auxiliary liver transplantation is a highly specialized procedure with the potential to offer a significant advantage for patients with acute liver failure, especially younger patients. At Broad Health, our team of experts is dedicated to providing the best care, ensuring that both donors and recipients achieve optimal outcomes.