《55-auxiliarylivertransplantation.》

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1、55AuxiliaryLiverTransplantationCARLOSMARGARITTheconceptofauxiliarylivertransplantation(ALT)isSurgicaltechniques816thatanewdonorliverisimplantedwithoutcompleteHeterotopicauxiliarylivertransplantation817removalofthenativediseasedliver.Thus,thepatientisAdvantagesanddisadvantages817leftwith

2、twolivers,thegraftandthenative.Theauxil-Auxiliarypartialorthotopicliveriarylivergraftcanbeplacedintwopositions:thehet-transplantation818erotopicpositioninwhichtheliverisimplantedintherightparacolicgutter,caudaltothenativeliver,andtheHeterotopicauxiliarylivertransplantationwithorthotopic

3、position,wherebyaportionofthenativeportalveinarterialization818liverisresectedandapartialgraftisimplantedintheAuxiliarylivertransplantationforfulminantvacatedresectionsite.hepaticfailure821Intheearlydaysoflivertransplantation(LT),theSelectioncriteria821rationaleforusingheterotopicauxili

4、arylivertrans-Criteriatodecideontheauxiliaryliverplantation(HALT)wasthedifficultyanddangeroftransplantationtechnique822removingtheliverofpatientssufferingfromend-stagePostoperativecourseandgraftfunction822livercirrhosiswithportalhypertension,massiveascites,Withdrawalofimmunosuppressiona

5、ndcoagulationdisorders.Significantbloodlossandandgraftremoval823hemodynamicinstabilityduringhepatectomywithinfe-Experienceinauxiliarylivertransplantationforriorvenacavaresectionwerecommoneventsleadingfulminantliverfailure824tohighperioperativemortality.Atthattime,deceasedAuxiliarylivert

6、ransplantationforinbornerrorsdonorlivergraftswereobtainedaftercardiacarrestofofmetabolism826thedonorbecausebraindeathhadnotbeenlegallyaccepted;moreover,theimmunosuppressionavailableAuxiliarylivertransplantationforsmall-for-sizewasnotveryefficientand,consequently,severeischemic-livingdon

7、orgraftlivertransplantation826reperfusioninjuryandrefractorygraftrejectionwerecom-Auxiliarylivertransplantationforchronicmoncomplicationsleadingtograftfailureandpatientliverfailure827death,asretransplantationwasalmostimpossible.Leavingthenativeliverinplacewithitsresidualfunctio