<s>[INST] context: Acute fulminant liver failure for any cause Following arc the types of liver transplantation: Cadaver donor transplantation: The donor liver is obtained from a person who is diagnosed as brain dead whose family volunteers to donate the organ for transplantation. Living donor transplant: A healthy family member or a volunteer donates pa of his liver for transplantation. Ohotropic liver transplant: it involves the replacement of the patient's diseased liver with the donor's liver. Auxiliary liver transplant Auxiliary transplantation (A-OLTX): Here the patient's liver is not removed. Pa of the liver of a healthy adult donor (living or cadaver) is transplanted into the recipient, alongside pa of the patient's own liver. Auxiliary heterotopic liver transplantation is theoretically attractive because it leaves the recipient's liver in place. The surgical trauma of hepatectomy is avoided, and failure of the graft does not necessarily lead to the death of the patient or a second, emergency transplantation. Another advantage is that matching the body sizes of the donor and the recipient is not mandatory, which increases the number of possible donors The following aicle-"Auxiliary Paial Ohotopic Living Donor Liver Transplantation: Kyoto University Experience" (at the .following website latp://www.inedscape.combiewaicle/500102) mentions four indications for auxiliary paial ohotopic liver transplantation: reversible fulminant hepatic failure non-cirrhotic metabolic liver disease snzall-for-size grafts for ABO-incompatibility Fultninant hepatic failure: Total ohotopic liver transplantation (OLTX) is a lifesaving therapeutic option for patients with FI-1F, but requires lifelong immunosuppression to maintain the graft. Auxiliary paial ohotopic liver transplantation whereby only a poion of the native liver is removed, and the remainder of the native liver is left in situ, provides temporary suppo until the native liver recovers and then immunosuppression can be withdrawn. The advantage claimed for APOLT in non-cirrhotic metabolic liver disease (most commonly Crigler-Najjar syndrome) is that it can compensate for enzyme deficiencies without complete removal of the native liver, which may have to aid the recipient in case of potential graft failure. The remaining native liver could benefit in the future from potential success in gene treatment Transplants of ABO-incompatible grafts are often unavoidable due to the limited number of potential donor candidates. A high incidence of early graft failure with a high rate of binary and vascular complications in ABOincompatible liver transplantation was repoed. The remnant native liver could sustain a patient's life if the anticipated graft failure occurred in an ABO-incompatible case. The rationale of APOLT for a small-for-size graft is that the remnant native liver is expected to suppo the function of the implanted graft during the early post-operative period. The graft liver expands its function in propoion to volume growth. After the graft liver has grown sufficiently, it can be expected to meet the hepatic functional demands of the recipient. The following aicle "Auxiliary paial liver transplantation for end-stage chronic liver disease" in The New England Journal of Medicine Volume 319:1507-1511December 8, 1988Nutnber 23 (at the following website gi/content/abstract/319/23/1507) mentions another indication for A-OLTX - End-stage chronic liver disease who are high-risk patients. These patients are not accepted for ohotopic liver transplantation because of massive ascites, deficient clotting function, cachexia, or poor pulmonary reserve. So we see that all the options except 'b' are indications for A-OLTX We have chosen acute liver ds. as the answer as it's the probably the most common indication as evident by maximum number of aicles on the net describing A-OLTX for acute liver failure. This book -"Atlas of Upper Gastrointestinal and Hepato-Pancrato-Biliary surgery- publisher: Springer Berlin Heidelberg " mentions only acute liver failure as an indication for A-OLTX. [/INST] question: Auxiliary ohotopic liver transplant is indicated for: | options: A: etabolic liver disease B: As a standby procedure until finding a suitable donor C: Drug induced hepatic failure D: Acute fulminant liver failure for any cause | answer: D </s>