A case of primary non-function following adult-to-adult living donor liver transplantation.
We report a case of primary non-function of graft liver following adult-to-adult living donor liver transplantation. The recipient was a 43-year-old male with hepatitis B-associated liver cirrhosis. The donor was a 28-year-old brother of the recipient. We transplanted a left lobe graft from the donor weighing 550 g, in which 20% macrovesicular steatosis was observed. Total ischemic time was less than 40 minutes. The recipient presented a marked impairment of coagulation profile and marked elevation of liver enzymes without any evidence of flow disturbance of the liver vessels, which was very similar to the clinical course of primary non-function following cadaveric donor liver transplantation. We performed retransplantation using a cadaveric whole liver graft on the second day after the initial operation and the recipient survived without any complications. A resected graft liver specimen showed total necrosis of hepatocytes without intravascular thrombosis. We concluded that failure of the living donor graft was due to primary non-function occurring in the adult recipient.
Hwang
Shin
S
Department of General Surgery, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Poongnap-dong, Songpa-gu, Seoul, 138-736, Korea. shwang@www.amc.seoul.kr
Lee
Sung-Gyu
SG
Lee
Young-Joo
YJ
Park
Kwang-Min
KM
Choi
Dong-Nak
DN
Ahn
Chul-Soo
CS
Min
Pyung-Chul
PC
D000328:Adult; D006801:Humans; D008103:Liver Cirrhosis / Q000601:surgery; D008111:Liver Function Tests; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D012086:Reoperation; D017211:Treatment Failure