Segmental auxiliary liver transplantation: a new approach to an old problem.

Long-term results after a new technique of partial heterotopic auxiliary liver transplantation carried out in pigs are presented. There are three main characteristics of this technique: (1) hemihepatectomy on the bench to solve the problem of space, (2) laterolateral vena cava anastomosis through which it is possible to fix the graft to the host's inferior vena cava. The above anastomosis is fashioned as close as possible to the right atrium and (3) partial diversion of the portal blood through the graft, while maintaining adequate portal blood for the host liver. Of the four animals that underwent transplants, three survived for more than 12 hr. One animal died after 1 day and another was sacrificed after 82 days. At this time, one animal is still alive, 8 months following transplantation and appears to enjoy a normal life. The present technique appears to anticipate the problem of space, of graft congestion, of graft atrophy, and mainly, the problem of functional competition between the graft and the host liver.