[Gazeous necrosis of the liver due to hepatic artery thrombosis after liver transplantation].
An emergency liver transplantation was performed in a 22 year-old female for fulminant hepatitis. The donor had had splenectomy with portal vein thrombosis which was diagnosed and removed during portoscopy. Nineteen days later, abdominal pain with shock and hepatic failure occurred. X-rays showed pneumoperitoneum and aeric images in the liver area. Laparotomy disclosed massive liver necrosis with gaz under the Glisson's capsula. The hepatic artery was thrombosed. In spite of emergency retransplantation, the patient died 8 days later, due to systemic aspergillosis. Thrombosis of hepatic artery was particular by the importance of gaz-forming infection, and emphasizes the role of rejection. The discovery of portal thrombosis allows to outline the precautions necessary in case of splenectomized donors. The severeness of aspergillosis is underscored.
Sardin
B
B
Département d'Anesthésie-Réanimation Chirurgicale, CHU Dupuytren, Limoges.
Savy
F P
FP
Valleix
D
D
Bertrand
H
H
Peze
P
P
Ferre-Boulanger
F
F
Desport
J C
JC
Catanzano
G
G
Descottes
B
B
D000328:Adult; D001228:Aspergillosis / Q000150:complications; D005260:Female; D006499:Hepatic Artery / Q000503:physiopathology*; D006505:Hepatitis / Q000601:surgery*; D006801:Humans; D008107:Liver Diseases / Q000150:complications* / Q000473:pathology; D016031:Liver Transplantation / Q000009:adverse effects*; D008172:Lung Diseases, Fungal / Q000150:complications; D009336:Necrosis; D013927:Thrombosis / Q000150:complications*
Nécrose gazeuse du foie par thrombose de l'artère hépatique après transplantation hépatique.