Living Donor Auxiliary Partial Orthotopic Liver Transplantation for Acute Liver Failure: A Case Report.

Acute liver failure (ALF) is a life-threatening end-stage liver disease, causing high mortality all over the world. Here, we presented a 54-year-old male patient, suffering from drug-induced ALF on the basis of hepatitis B virus (HBV) infection. At that time, the only available donor we could find was his 44-year-old sister. We performed living donor auxiliary partial orthotopic liver transplantation (APOLT) on the second day of admission. The right lobe of the donor liver was implanted into the recipient orthotopically. The actual graft-to-recipient weightratio (GRWR) was 0.85% and the postoperative immunosuppression was a combination of tacrolimus, mycophenolate mofetil (MMF) and steroids. The patient recovered consciousness on the third post-operative day and was discharged with normal liver function after 43 days of transplantation. After a 48-month follow-up, the recipient has been restored to normal life and the immunosuppression has been tapered off (tacrolimus, 1 mg/d). Besides, the size of the native liver has extended to 29% of standard liver volume (SLV) and the native liver cells have returned to normal pathological condition. In conclusion, APOLT is a life-saving treatment for ALF with excellent post-operative outcomes.