Donor Liver Transplantation For Biliary Atresia Research Articles

Gallstone ileus at 17 years after living donor liver transplantation: A case report

Gallstone ileus (GI) occurs in <0.1% of all cases of mechanical bowel obstruction. There have been a few reports of GI occurring after Kasai procedures or Roux-en-Y anastomosis for bariatric surgery. We herein report a case of GI that occurred over 17 years after liver transplantation (LT). A 33-year-old woman who had undergone living donor LT for biliary atresia at 16 years old and had been regularly followed on an outpatient basis in our hospital presented with the sudden onset of increased abdominal distension, pain, and nausea. Enhanced abdominal computed tomography showed dilatation of the intrahepatic bile duct and the whole intestinal tract of the Roux limb as well as ischemic changes near the jejuno-jejunal anastomosis. On laparotomy, a movable and hard foreign body was palpated in the intestinal tract close to the jejuno-jejunal anastomosis site. Enterotomy was performed, and a 4-cm gallstone was removed. The patient had a good postoperative course and was discharged on postoperative day 12. Although GI after LT is a rare complication, it may need to be differentiated as a cause of ileus. An accurate differential diagnosis and early reliable intervention for stone removal will help prevent serious bowel complication, which may lead to graft dysfunction.

Balloon-occluded retrograde transvenous obliteration in a patient with hyperammonemic encephalopathy after living donor liver transplantation

Received December 20, 2006; accepted January 1, 2007.A 23-year-old woman underwent living donor livertransplantation for biliary atresia in 1996. The postop-erative course was uneventful, and the patient faredwell with tacrolimus-based immunosuppression.In May 2006, she complained of general fatigue andunconsciousness. The laboratory data showed mild in-creases in liver enzymes (aspartate aminotransferase,78 IU/L; alanine aminotransferase, 74 IU/L) and totalbile acid (237 mol/L), as well as hyperammonemia(NH