Biological Effect of Heterotopic Liver Transplantation

  • X.-Y. Zhang
  • A. M. Wheatley


Orthotopic liver transplantation (OLT), in which the diseased native liver is totally replaced by the donor in the normal anatomical position, has become an established therapeutic option for patients with end-stage acute or chronic liver disease. However, some disadvantages of OLT still remain, e.g., patients with advanced chronic liver disease often present with a combination of portal hypertension, abundant venous collaterals, and severe clotting disturbances, which makes dissection and removal of the host liver difficult to perform. Intraoperative, the OLT recipient is challenged by a decreased cardiac output, which is further compromised by the decreased venous return during the anhepatic phase unless a venovenous bypass is used. Furthermore, in patients with acute liver failure, the extra operative stress endured during removal of the native liver may threaten the patient’s recovery. In contrast, heterotopic liver transplantation (HLT) can avoid these problems, in particular when the host liver preserves biosynthetic and clearance functions or when the potential for recovery after acute liver failure is present. Initial results of the HLT performed either in animals in 1950s or in patients in 1960s were, however, very disappointing due to inadequate techniques and ineffective immunosuppression [1, 6, 8, 30]. Only 50 HLT were performed on 48 patients up to 1980 [4].


Liver Transplantation Inferior Vena Cava Orthotopic Liver Transplantation Acute Liver Failure Native Liver 
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© Springer-Verlag Berlin Heidelberg 1998

Authors and Affiliations

  • X.-Y. Zhang
  • A. M. Wheatley

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