title: Liver laceration associated with severe seizures after living donor liver transplantation.
abstract: Hemorrhagic complications commonly occur early after liver transplantation (LT), sometimes requiring emergent relaparotomy. However, active bleeding from the liver graft itself is a rare but life-threatening complication after living donor liver transplantation (LDLT). We report an unusual case of liver laceration with massive bleeding, associated with severe epileptic seizures as a result of tacrolimus-induced leukoencephalopathy, after LDLT. The patient was successfully rescued by conventional surgical management without a second transplantation. In conclusion, to our knowledge this is the first reported case of graft rupture due to immunosuppression-associated leukoencephalopathy after LT.
authors.affiliation: Advanced Surgical Science and Technology Division, Department of Surgery, Graduate School of Medicine, University of Tohoku, Sendai, Japan. satokazu@mail.tains.tohoku.ac.jp
authors.forename: Kazushige
authors.initials: K
authors.lastname: Sato
authors.forename: Satoshi
authors.initials: S
authors.lastname: Sekiguchi
authors.forename: Yorihiro
authors.initials: Y
authors.lastname: Akamatsu
authors.forename: Naoki
authors.initials: N
authors.lastname: Kawagishi
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Enomoto
authors.forename: Takeru
authors.initials: T
authors.lastname: Iwane
authors.forename: Akira
authors.initials: A
authors.lastname: Sato
authors.forename: Keisei
authors.initials: K
authors.lastname: Fujimori
authors.forename: Susumu
authors.initials: S
authors.lastname: Satomi
mesh_terms: D000293:Adolescent; D001656:Biliary Atresia / Q000175:diagnosis / Q000601:surgery; D004630:Emergencies; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D022125:Lacerations / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D007813:Laparotomy / Q000379:methods; D008099:Liver / Q000473:pathology* / Q000601:surgery; D016031:Liver Transplantation / Q000009:adverse effects* / Q000379:methods; D019520:Living Donors; D019106:Postoperative Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D018570:Risk Assessment; D012640:Seizures / Q000188:drug therapy / Q000209:etiology*; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents