[Heterotopic hepatic transplantation in fulminating hepatitis]

Based on a rare case of heterotopic hepatic transplantation (HHT) carried out in a 24 year old woman for fulminant hepatitis of viral origin, the authors present the technique used and the principal post-operative events (rejection, resistant large volume ascites and the clinical course for the liver itself). They discuss the rarity of success in this type of graft, where the causes of failure in man have not been entirely elucidated: the venous pre-existing portal hypertension is probably a very unfavorable factor. The place of this particular type of HHT in cases of acute severe hepatic failure is then proposed: this may produce a smaller operative insult than orthotopic transplantation and, in this respect, deserves consideration when advanced hepatic encephalopathy is present, notably due to delay in finding a suitable graft.