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• W2158383513 abstract "Liver is an organ that can regenerate. If we could support the liver function during acute insult, there is a possibility that native liver could regenerate over a period of time. Auxiliary partial orthotopic liver transplants (APOLT) is a surgical procedure by which donor liver graft is placed alongside the native liver following resection of part of the native liver replacing it with a segmental graft. Here, we report the first successful APOLT in India for ALF, in whom native liver has regenerated and immunosuppression was withdrawn successfully. A two and half year old child with acute liver failure underwent APOLT using left lateral segment from the donor. Histopathology of the explant left lobe of liver showed near total absence of hepatocytes. She was started on tacrolimus and steroids and discharged home after four weeks of surgery. Histopathology of the native liver to look at proliferative activity of hepatocytes using Ki-69 expression, Diisopropyl Iminodiacetic Acid (DISIDA) scan to look at differential activity and CT volumetry to look at differential volume of transplanted and native lobe were performed every six months. At 2 years post APOLT, these investigations showed that the native liver has regenerated and contributed to around 50% of volume and functionality. At this point, immunosuppression was gradually weaned off over the following six months, allowing low-grade rejection of the graft, which progressively lead to fibrosis and graft atrophy. CT and DISIDA scan done immediately after stopping immunosuppression confirmed that native right lobe contributed to 96% of total function and 83% respectively. This is a proof from living a model that liver can regenerate from near absence of hepatocytes in ALF. The child is completely off all immunosuppressive medications and has normal liver function tests and can live the rest of her life with her own liver. Liver is an organ that can regenerate. If we could support the liver function during acute insult, there is a possibility that native liver could regenerate over a period of time. Auxiliary partial orthotopic liver transplants (APOLT) is a surgical procedure by which donor liver graft is placed alongside the native liver following resection of part of the native liver replacing it with a segmental graft. Here, we report the first successful APOLT in India for ALF, in whom native liver has regenerated and immunosuppression was withdrawn successfully. A two and half year old child with acute liver failure underwent APOLT using left lateral segment from the donor. Histopathology of the explant left lobe of liver showed near total absence of hepatocytes. She was started on tacrolimus and steroids and discharged home after four weeks of surgery. Histopathology of the native liver to look at proliferative activity of hepatocytes using Ki-69 expression, Diisopropyl Iminodiacetic Acid (DISIDA) scan to look at differential activity and CT volumetry to look at differential volume of transplanted and native lobe were performed every six months. At 2 years post APOLT, these investigations showed that the native liver has regenerated and contributed to around 50% of volume and functionality. At this point, immunosuppression was gradually weaned off over the following six months, allowing low-grade rejection of the graft, which progressively lead to fibrosis and graft atrophy. CT and DISIDA scan done immediately after stopping immunosuppression confirmed that native right lobe contributed to 96% of total function and 83% respectively. This is a proof from living a model that liver can regenerate from near absence of hepatocytes in ALF. The child is completely off all immunosuppressive medications and has normal liver function tests and can live the rest of her life with her own liver." @default.
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• W2158383513 date "2015-06-01" @default.
• W2158383513 modified "2023-09-30" @default.
• W2158383513 title "Liver Regeneration Following Fulminant Liver Failure; Proof From A Living Model" @default.
• W2158383513 doi "https://doi.org/10.1016/j.jceh.2015.07.135" @default.
• W2158383513 hasPublicationYear "2015" @default.
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