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APOLT and RAPID Techniques

  • Umberto CilloEmail author
Chapter
Part of the Updates in Surgery book series (UPDATESSURG)

Abstract

Auxiliary partial orthotopic liver transplantation (APOLT) has been introduced into clinical practice to support liver function in the presence of hepatic failure with a potential for recovery of the native liver. Alternatively, APOLT is adopted in the presence of an inherited metabolic defect to be corrected with “transplantation gene therapy” with a potential for a future cell/gene therapy allowing for subsequent maintenance of the native liver only. Technical complexities have limited its widespread clinical application. Resection and partial transplantation of liver segments 2–3 with delayed total hepatectomy (RAPID) includes a temporary auxiliary transplant of the left lateral segments (either from split liver or from living donor liver transplantation) regenerating rapidly (according to the ALPSS, associating liver partition and portal vein ligation for staged hepatectomy principles) to reach a volume and functions sufficient to sustain life. In a second step, the remnant native liver is removed. The RAPID technique may provide an extra donor source particularly in view of the expected expansion of transplants in patients with colorectal cancer metastases. Herein we describe the first Italian case of RAPID. The report is the first worldwide that includes a fully laparoscopic second step (videolaparoscopic right hepatectomy).

Keywords

Auxiliary transplantation APOLT technique RAPID technique Extra donor source Living donation Videolaparoscopic approach 

Supplementary material

Video 17.1

(MP4 1779412 kb)

Video 17.2

(MP4 1673828 kb)

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of Surgery, Oncology and GastroenterologyUniversity of PaduaPaduaItaly
  2. 2.Hepatobiliary Surgery and Liver Transplant UnitPadua University HospitalPaduaItaly

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