1: Clin Transplant 1999 Aug;13(4):300-4

Severe late acute allograft rejection in a child after living-related auxiliary partial orthotopic liver transplantation for ornithine transcarbamylase deficiency

Komatsu H, Inui A, Fujisawa T, Sogo T, Miyagawa Y, Inui M, Uemoto S, Inomata Y,
Tanaka K
Department of Pediatrics, National Defense Medical College, Saitama, Tokorozawa
City, Japan.

Abstract
Auxiliary liver transplantation (ALT) is known to correct liver-based metabolic
disorders. However, it remains unclear whether the presence of a native liver
influences the long-term prognosis of ALT for metabolic diseases. We reported on
a 4-yr-old girl who had undergone living-related auxiliary partial orthotopic
liver transplantation (APOLT) for ornithine transcarbamylase deficiency and
experienced severe late acute rejection 18 months after liver transplantation,
during weaning of immunosuppressive agents. Results of histological analysis of
the graft indicated very severe acute rejection (rejection activity index, 9/9),
and computed tomography revealed graft liver atrophy. These observations suggest
the possibility that severe rejection might occur in APOLT, especially during
weaning of immunosuppression