Abstract • The ability of a heterotopic graft to prolong life in animals dying in hepatic coma due to liver necrosis has never been definitely established. Acute hepatic failure was produced in 15 dogs by an hour of total interruption of the hepatic blood supply. Nine dogs received an intrathoracic hepatic homograft concurrently. Nontransplanted dogs died within 21 hours in hepatic coma, while transplanted dogs survived significantly longer (P <.001). In all transplanted dogs, biological signs of hepatic failure were corrected in 24 hours. In four animals, the graft was removed on the fifth postoperative day. Two of those survived for 10 and 15 days respectively with normal hepatic function. These results demonstrate that a temporary heterotopic liver transplant is able to support life during the acute, normally lethal phase in dogs with massive liver necrosis. (Arch Surg 112:74-78, 1977) References 1. Benhamou JP, Rueff B, Sicot C: Etude critique des traitements actuels de l'insuffisance hépatique grave . Rev Fr Etud Clin Biol 13:651-658, 1968. 2. Kuster G, Woods JE: Auxiliary liver transplantation in dogs as temporary support in acute fulminating hepatic necrosis . A nn Surg 176:732-735, 1972.Crossref 3. Lilly JR, Anderson KD, Hill JL, et al: Auxiliary liver transplantation in acute liver failure . J Pediatr Surg 7:492-498, 1972.Crossref 4. Huguet C, Bloch P, Opolon P, et al: Traitement des nécroses aiguës du foie par transplantation hépatique . J Chir 108:397-406, 1974. 5. Misra MK, P'eng FK, Sayhoun A, et al: Acute hepatic coma: A canine model . Surgery 72:634-642, 1972. 6. Lecompte Y, de Riberolles C, Grange D, et al: Canine intrathoracic hepatic homograft . Arch Surg 109:809-811, 1974.Crossref 7. Rappaport AM, MacDonald MM, Borowy ZJ: Hepatic coma following ischemia of the liver . Surg Gynecol Obstet 97:748-762, 1953. 8. Van der Heyde MN, Jerusalem C, Schimdt W, et al: The influence of hemodynamies on the microstructure of the heterotopic liver graft . Eur Surg Res 2:152, 1970. 9. Hess F, Jerusalem C, Van der Heyde MN: Advantages of auxiliary liver homotransplantation in rats . Arch Surg 104:76-80, 1972.Crossref 10. Starzl TE, Porter KA, Kashiwagi N, et al: Portal hepatotrophic factors, diabetes mellitus and acute liver atrophy, hypertrophy and regeneration . Surg Gynecol Obstet 141:843-858, 1975. 11. Franco D, Grange D, Chauvaud S, et al: Ischemic necrosis of the liver in the rat . Eur Surg Res 4:276, 1972. 12. Bloomer JR, Waldmann TA, Mclntire K, et al: Relationship of serum α-fetoprotein to the severity and duration of illness in patients with viral hepatitis . Gastroenterology 68:342-350, 1975.
Archives of Surgery – American Medical Association
Published: Jan 1, 1977