Case Of Successful Liver Transplantation Research Articles

Successful liver transplantation from a deceased donor who was on hemodialysis for 10 years

Objective: to analyze the possibility of using the liver of a donor undergoing hemodialysis as a transplant.Materials and methods. A case of successful liver transplantation (LT) from a 40-year-old deceased donor, who had been on hemodialysis for 10 years for chronic pyelonephritis and nephrosclerosis, is presented. Of the known hemodialysis complications of chronic kidney disease, the donor’s medical records showed anemia and grade 3 arterial hypertension.Results. The recipient’s post-LT period had no significant differences from the postoperative period of those that received liver from donors with standard criteria.Conclusion. Our first experience with the use of a liver transplant from a donor who was on hemodialysis, in the absence of other risk factors, suggests that the liver of this category of donors can be used for transplantation.

Acute Liver Failure and Concomitant Severe Acute Pancreatitis Due to Hepatitis B: Successful Management with Liver Transplantation

Acute pancreatitis in the setting of acute liver failure is an uncommon but challenging clinical entity. Although the presence of acute pancreatitis in acute liver failure has important prognostic implications, it should not be considered a contraindication to liver transplantation. Here we present a case of successful liver transplantation in a patient with acute hepatitis B virus acute liver failure with concurrent necrotising pancreatitis and multiple organ dysfunctions.

Deceased Donor Diver Transplantation Using a Lacerated Graft With Isolated Hyperbilirubinemia

The main limitation of liver transplantation is the shortage of organ donors. The scarcity of donor has led to the increased use of marginal grafts. An injured liver, especially lacerated, is generally considered as the marginal graft having high risk and poor outcome because it is susceptible to malfunctioning, bleeding, bile leakage and infection after liver transplantation. However, some authors have reported successful liver transplantation using injured graft under the meticulous care and careful selection of recipient. We report a case of successful liver transplantation using a right liver graft after in situ left hepatectomy with a lacerated graft with hyperbilirubinemia. Recipient was 52 years old male patient with alcoholic liver cirrhosis. He admitted due to esophageal variceal bleeding with a MELD score of 27 and Child Pugh score of 11. The donor was a 23 years old male who had multiple injuries from fall down. Emergency laparotomy was performed for intraabdominal bleeding. But his condition was deteriorated to brain death and liver function test revealed high bilirubin level (6.04mg/dL) and elevated AST/ALT levels (213/224U/L). The graft liver has 5cm vertical linear laceration in the inferior surface of the liver and it was sutured by Nylon 1‐0 in the previous laparotomy. Procurement team decided to perform in situ left hemihepatectomy to discard an injured left liver because bile duct ligation or injury during previous emergency operation was suspected due to hyperbilirubinemia. After liver transplantation using a right graft, liver function was rapidly normalized and he discharged without any major complication.

Successful orthotopic liver transplantation after biliopancreatic diversion with duodenal switch

Obesity is a major public health concern. In the United States, an estimated 33.8% of adults have a body mass index (BMI) Z30 [1]. In parallel with the evolving obesity epidemic, nonalcoholic fatty liver disease (NAFLD) has rapidly become the most common cause of chronic liver disease worldwide. It is closely associated with a spectrum of disease including steatosis, nonalcoholic steatohepatitis (NASH), cirrhosis, and hepatocellular carcinoma [2]. In patients undergoing bariatric surgery, steatosis, NASH, and fibrosis can be shown to be present in 61%, 36%, and 16% of patients, respectively [3]. As a consequence, NASH has become one of the most common indications for liver transplantation [2]. To this day, bariatric surgery remains the most effective option for the treatment of morbid obesity and its associated complications. Histologic changes of NAFLD have been shown to improve significantly after weight loss surgery [4], although a paradoxical accelerated form of NASH has also been documented with rapid weight loss [5]. Cases of hepatic failure leading to death or transplantation after bariatric surgery can be found in the literature. Most cases appear to be associated with the jejunoileal bypass procedure and the classic biliopancreatic diversion [6]. In contrast, the biliopancreatic diversion with duodenal switch (BPD/DS), developed in the early 1990s, has only had anecdotal reports of associated severe hepatic failure [7]. To date, liver failure after BPD/DS remains an extremely rare occurrence, and no case of successful liver transplantation in this context has been reported. We report herein a first case of successful orthotopic liver transplantation for subacute hepatic failure 8 months after laparoscopic BPD/DS. (Surg Obes Relat Dis 2013;9;e46–e48.) r 2013

Successful Liver Transplantation for a Child With Life-Threatening Recurrent Bleeding Episodes Due to Congenital Factor X Deficiency: A Case Report

Factor X (FX) deficiency is a rare, autosomal-recessive coagulation disorder. Diagnosis can be confirmed by a factor X assay. Although fresh frozen plasma and prothrombin complex concentrates have been used as a temporary treatment of bleeding symptoms and preparation for surgery, frequent transfusion has its risk and prothrombin complex is not available in Korea. We report the first pediatric case of successful liver transplantation for the correction of a severe congenital FX deficiency in a child with recurrent life-threatening hemorrhagic episodes.

Liver Transplantation for Acute Liver Failure at 11-Week Gestation with Successful Maternal and Fetal Outcome

Acute liver failure (ALF) during pregnancy is very uncommon. Pregnancy-specific liver conditions like hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome and acute fatty liver of pregnancy can cause ALF at term or postpartum, but, typically occur during the third trimester. Most of these patients recover spontaneously after delivery, but, on occasion, they require liver transplantation in the postpartum period. However, ALF during the first and second trimester of pregnancy requiring antepartum liver transplantation is rare. Only fifteen cases of liver transplantation during pregnancy have been reported, and very few occurred during the first trimester. We report a Woman who developed acute liver failure during the first trimester of pregnancy and underwent successful liver transplantation at 11-week gestation, followed by successful delivery of the fetus at 30 weeks. To our knowledge, this is the earliest case of successful liver transplantation during pregnancy followed by successful fetal outcome. We discuss management of the patient and fetus before, during, and after liver transplantation and review the literature on antepartum liver transplant in pregnancy.

Liver transplantation in a patient treated by sorafenib for hepatocellular carcinoma

Sorafenib is a multikinase inhibitor currently used in the palliative treatment of advanced hepatocellular carcinoma. In patients with small hepatocellular carcinoma, sorafenib could be suggested as neoadjuvant therapy to control tumor growth during waiting time for liver transplantation. However, up to now, safety of liver transplantation in patients undergoing sorafenib treatment is not known. Herein, we report a case of successful liver transplantation in a patient treated by sorafenib for hepatocellular carcinoma. In this patient, liver transplantation was performed safely and histological examination of explanted liver evidenced complete necrosis of the largest tumor nodule.

Liver transplantation from a non-heart-beating donor after pulmonary failure: Report of a case

We report a case of successful liver transplantation after controlled donor after cardiac death procurement from a donor who died of pulmonary failure. The donor was a 28-year-old woman with idiopathic pulmonary fibrosis, whose life support could not continue when her condition deteriorated rapidly while waiting for a suitable donor for lung transplantation. She was on noninvasive negative pressure ventilatory support before the donor organs were procured.

Living donor liver transplantation for congenital absence of the portal vein in a child with cardiac failure

Congenital absence of the portal vein (CAPV) requires liver transplantation when encephalopathy develops. However, transplantation has technical difficulties because no collateral circulation exists except for the portosystemic shunt. Ligating the shunt will cause disastrous mesenteric venous congestion. We report a 19-month-old female infant with CAPV, who had portosystemic encephalopathy and cardiac failure, and underwent living donor liver transplantation with a partial clamp technique using a vein graft. This is the first case of successful liver transplantation for CAPV with cardiac failure.

Potentiation of Acetaminophen Hepatotoxicity by Phenytoin, Leading to Liver Transplantation

We report the case of a 22-year-old man who developed fulminant hepatic failure 3 days after an intentional acetaminophen overdose. The patient had a history of a seizure disorder for which he was taking phenytoin. The acetaminophen level at presentation was in the "nontoxic" range. Emergent liver transplantation was performed 4 days after the ingestion. This is the first reported case of successful liver transplantation for acetaminophen-induced fulminant hepatic failure in the setting of phenytoin therapy.

Liver transplantation for chronic graft-versus-host disease: case report with 10-year follow-up

Graft-versus-host disease (GVHD) is a frequent complication of bone marrow transplantation (BMT). Chronic GVHD (cGVHD) may lead to irreversible liver failure. We report a case of successful liver transplantation (LT) for end-stage liver failure because of cGVHD that had developed 22 months after BMT in a 24-year-old male. Re-transplantation was necessary 6 months later because of intrahepatic ischaemic type biliary tract lesions. He is now in excellent condition 10 years after the first transplant. This experience and the review of literature indicate that LT can cure GVHD-related chronic liver failure. Recurrent GVHD in the allograft has not yet been reported.

LIVER TRANSPLANTATION FOR METASTATIC HEMANGIOPERICYTOMA ASSOCIATED WITH HYPOGLYCEMIA

We report a case of successful liver transplantation in a young man with metastatic hemangiopericytoma confined to the liver. He had a primary retroperitoneal hemangiopericytoma removed in 1982 and was diagnosed as having liver metastases 8 years later. Subsequently, he developed hypoglycemia, which did not respond to chemotherapy. Hepatectomy and transplantation resolved his hypoglycemic attacks. He remained well and symptom free for 4 years. Liver transplantation can provide effective palliation and should be considered in carefully selected patients with localized metastatic cancer.

Liver transplantation for erythropoietic protoporphyria: Report of a new case with subsequent medium-term follow-up

We report a new case of successful liver transplantation in a 36-year-old patient with terminal hepatic failure due to erythropoietic protoporphyria. Data regarding protoporphyrin levels in erythrocytes and feces, before and after transplantation, seem to indicate that in this case protoporphyrin overproduction was in part due to liver synthesis. Four years after surgery, the patient is completely free of skin photosensitivity. His liver function tests are normal; there are no visible protoporphyrin deposits or ultrastructural abnormalities in his new liver. However, recurrence of the disease in the long term cannot be excluded, since erythrocyte protoporphyrin levels remained elevated after liver transplantation.