Clinical heterotransplantation of the liver.

Abstract

A 7-month-old child with extrahepatic biliary atresia was treated by orthotopic transplantation of a chimpanzee liver after preliminary revascularization in the recipient of both kidneys from the same animal donor for the purpose of depleting preformed heterospecific antibodies. Unfortunately, there was evidence that the child was presensitized to white cell antigens by preoperative blood transfusions with the consequent development of lymphocytotoxic antibodies that reacted with donor tissues. When the chimpanzee kidneys were revascularized in the recipient, they appeared to be hyperacutely rejected. The liver did not suffer the same fate but the child failed to awaken from anesthesia and died one day later. It was not possible to determine if the death was caused by metabolic complications that are common with this procedure even when homografts are used, if the employment of a chimpanzee liver had any specific role in the tragic outcome, or if a presensitized state was an important adverse factor.