Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 7, 2015; 21(9): 2840-2847
Published online Mar 7, 2015. doi: 10.3748/wjg.v21.i9.2840
Retrospective observation of therapeutic effects of adult auxiliary partial living donor liver transplantation on postpartum acute liver failure: A case report
Chuan-Yun Li, Wei Lai, Shi-Chun Lu
Chuan-Yun Li, Department of Hepatobiliary Surgery and Liver Transplantation Center, Beijing You-An Hospital, Capital Medical University, Beijing 100069, China
Wei Lai, Department of Hepatobiliary Surgery, the First People’s Hospital of Chengdu, Chengdu 610071, Sichuan Province, China
Shi-Chun Lu, Institute and Hospital of Hepatobiliary Surgery, Key Laboratory of Digital Hepatobiliary Surgery of Chinese PLA, Chinese PLA Medical School, Chinese PLA General Hospital, Beijing 100853, China
Author contributions: Li CY drafted the manuscript and statistical analyses; The experiments were designed by Lu SC; The experiments were performed by Lai W; Lu SC supervised and coordinated the study; all authors have read and approved the final manuscript.
Supported by Beijing Municipal Commission of Education, Grant No. KM201110025026; Projects of State Commission of Science and Technology of China, Grant No. 2012BAI06B01; and Organ Transplantation Research Fund from the Ministry of Health, Grant No. RHECC08-2012-08.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Shi-Chun Lu, MD, Institute and Hospital of Hepatobiliary Surgery, Key Laboratory of Digital Hepatobiliary Surgery of Chinese PLA, Chinese PLA Medical School, Chinese PLA General Hospital, No. 28, Fuxing Road, Haidian District, Beijing 100853, China. lsc620213@aliyun.com
Telephone: +86-10-63296493 Fax: +86-10-63296493
Received: September 22, 2014
Peer-review started: September 23, 2014
First decision: October 14, 2014
Revised: November 7, 2014
Accepted: December 1, 2014
Article in press: December 1, 2014
Published online: March 7, 2015
Processing time: 168 Days and 14.6 Hours
Abstract

We present a female patient with preterm labor, severe viral hepatitis B of acute phase, hepatic encephalopathy stage III and coma. After delivery, the illness was exacerbated and the patient presented with clinical signs of vital organ dysfunctions such as acute respiratory distress syndrome, cerebral edema and hypoxemia that needed mechanical ventilation. Emergency liver transplantation was recommended after multidisciplinary panel consultations. The donor, her mother, consented to donate her right liver. Auxiliary partial orthotopic living donor liver transplantion (APOLDLT) was performed. After operation, the patient was on triple medication of tacrolimus plus mofetil mycophenolate and prednisone for immunosuppression. The combination of anti-hepatitis B virus (HBV) immunoglobulin and entecavir was initiated for anti-HBV therapy. Both the patient and the donor recovered well without any complications. The patient was followed up regularly. Her liver function, clinical signs and symptoms improved significantly. Until now, the recipient has been living for more than 78 mo free of any complications. The APOLDLT is a life-saving modality for rescuing patients with high-risk acute liver failure following HBV infection without available donor and hence is recommended under standardized antiviral therapy coverage as stated above.

Keywords: Auxiliary partial orthotopic living donor liver transplant; Acute liver failure; Postpartum; Hepatitis B virus; Anti-hepatitis B virus immunoglobulin; Entecavir

Core tip: Auxiliary partial orthotopic living donor liver transplantation (APOLDLT) was performed on a female patient with preterm labor, severe viral hepatitis B of acute phase, hepatic encephalopathy and coma. The patient was treated with triple medication for immunosuppression, and combination of anti-hepatitis B virus (HBV) immunoglobulin and Entecavir for anti-HBV therapy after operation. The patient has been living for more than 78 mo free of any complications. The APOLDLT is a life-saving modality for rescuing patients with high-risk acute liver failure following HBV infection without available donor.