Xenogeneic Heterotopic Auxiliary Liver Transplantation (XHALT) promotes native liver regeneration in a Post-Hepatectomy Liver failure model

Nalu Navarro-Alvarez, Zurab Machaidze, Christian Schuetz, Alexander Zhu, Weihui H. Liu, Jigesh A. Shah, Parsia A. Vagefi, Nahel Elias, Leo Buhler, David H. Sachs, James F. Markmann, Heidi Yeh

Research output: Contribution to journalArticle


The liver’s regenerative capacity is unique, but too small a segment can overwhelm its ability to simultaneously regenerate and support the host, resulting in liver dysfunction and death. Here we tested a temporary Xenogeneic Heterotopic Auxiliary Liver Transplant (XHALT) from Gal-KO miniature swine in a baboon model of Post-Hepatectomy Liver Failure (PHLF) by 90%- hepatectomy. Immunosuppression consisted of CVF, ATG, FK 506 and steroids. 90%-hepatectomized animals died within 4–5 days with the clinical picture of PHLF, (high LFTs and bilirubin, ascites, encephalopathy and coagulopathy). The 10% remnants had macroscopic and histological evidence of severe steatosis and absence of hepatocyte replication. In contrast, the addition of XHALT prolonged survival up to 11 days, with the cause of death being sepsis, rather than liver failure. The remnant liver appeared grossly normal, and on histology, there was no evidence of fatty infiltration, but there was pronounced Ki-67 staining. In conclusion, temporary auxiliary xenografts have the potential to support a small for size liver graft while it grows to adequate size or provide an opportunity for organ recovery in acute liver failure.

Original languageEnglish (US)
Article numbere0207272
JournalPloS one
Issue number11
Publication statusPublished - Nov 2018
Externally publishedYes


ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General

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