Successful living donor liver transplantation for fulminant hepatic failure that manifested immediately after cesarean delivery |
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Authors: | Horikoshi Yoshimasa Itoh Hiroaki Kikuchi Suguru Uchida Toshiyuki Suzuki Kazunao Sugihara Kazuhiro Kanayama Naohiro Mori Akira Uemoto Shinji |
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Affiliation: | Department of Obstetrics and Gynecology, Hamamatsu University School of Medicine, Japan. |
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Abstract: | A 31-year-old pregnant woman was diagnosed as having acute hepatitis of unknown etiology and conservatively treated. An emergency cesarean delivery was performed 5 days later at 33 weeks and 3 days of gestation because of a gradual deterioration in liver function. Two days after the cesarean delivery, she lost consciousness in the evening (Glasgow coma scale [GCS] = 9) because of hepatic encephalopathy and was diagnosed as having fulminant hepatic failure (FHF). Five days after the cesarean delivery, the patient (blood type B) underwent a successful left lobe with caudate lobe (S1+2+3+4) liver transplantation from her father (blood type AB), an ABO-incompatible donor. At 1 year follow-up, she and her baby are in good medical condition. The drastic deterioration in hepatic function, despite intensive plasmapheresis and continuous hemodiafiltration, during the early postpartum period suggested a possible causative association between the termination of pregnancy and progression of FHF from acute hepatitis of unknown etiology. |
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