Published online Aug 28, 2017. doi: 10.4254/wjh.v9.i24.1022
Peer-review started: March 2, 2017
First decision: May 3, 2017
Revised: May 19, 2017
Accepted: July 14, 2017
Article in press: July 17, 2017
Published online: August 28, 2017
The place of liver transplantation in the treatment of severe iatrogenic liver injuries has not yet been widely discussed in the literature. Bile duct injuries during cholecystectomy represent the leading cause of liver transplantation in this setting, while other indications after abdominal surgery are less common. Urgent liver transplantation for the treatment of severe iatrogenic liver injury may-represent a surgical challenge requiring technically difficult and time consuming procedures. A debate is ongoing on the need for centralization of complex surgery in tertiary referral centers. The early referral of patients with severe iatrogenic liver injuries to a tertiary center with experienced hepato-pancreato-biliary and transplant surgery has emerged as the best treatment of care. Despite widespread interest in the use of liver transplantation as a treatment option for severe iatrogenic injuries, reported experiences indicate few liver transplants are performed. This review analyzes the literature on liver transplantation after hepatic injury and discusses our own experience along with surgical advances and future prospects in this uncommon transplant setting.
Core tip: Liver transplantation may represent the only option to manage severe iatrogenic liver injuries. Despite widespread interest, reported experiences indicate only a minority of liver transplants are performed, and the place of liver transplantation in this setting has not yet been widely discussed. Causes other than severe bile duct injuries during cholecystectomy are less common indications for liver transplantation. Urgent liver transplantation for the treatment of severe iatrogenic liver injury may require technically difficult and time-consuming surgical procedures. The centralization of complex surgery in tertiary centers and the early referral of patients with severe iatrogenic liver injuries are crucial.