1. Transplantation of the Liver,Experimental and Clinical.Experimental and Clinical Heterotopic Liver Homotransplantation.Karel B. Absolon,* Patrick F. Hagihara, Ward 0. Griffen Jr., RichardC. Lillehei, University of Minnesota, Dept. of Surgery.The problems of Heterotopic Liver Transplantation in the human infant,suffering of biliary atresia will be discussed.Objective: The technique of heterotopic liver homotransplantation,previously developed in the dog, was successfully applied in twohuman infants. In addition to blood chemistries, liver functiontests, serum protein patterns and levels of complement were seriallyexamined. Post mortem histological examination of the graftswas supplemented with angiographic x-ray studies of the hepatica7 PLY Fe hepatic vein and the portal vein; vinyl plastic castsof the vessels were also ebtained.Procedure: As donors served infants dying of congenital heartdisease, maintained by total body perfusion. The donor had performeda splenectomy, anastomosis of the transected left ileae artery tothe aortic segment containing the graft hepatic artery and theinferior vena cava of the graft served as outflow tract into theleft ileac vein of the donor. The portal vein was ligated inone infant and a porto-caval shunt was performed in the other.Results: One child survived for eight, the other for thirteen days.The liver functions improved in both infants; the death in thefirst was due to sudden hemorrhage from disruption of the arterialanastomosis. In the second patient leakage of bile developed atthe cholecystojejunostomy which in both infants served for drainageof bile. Histologically, patterns of rejection were noted in thegraft which could not be, completely aborted with Azathioprine andSteroids. The angiographic patterns and vinyl plastic casts showedan architecture not different from a normal infant liver.Karel B. Absolon, 2714 W. 10th Amarillo, Texas