title: Liver retransplantation with external biliary diversion for progressive familial intrahepatic cholestasis type 1: a case report.
abstract: PFIC1, originally described as "Byler disease," is characterized by cholestatic feature and chronic diarrhea. Many patients require LT for the cure, but intractable diarrhea and prolonged growth retardation after LT are serious complications limiting the ultimate outcome of LT for this disease. EBD has recently been shown to be a promising and effective treatment. Recently, we successfully treated a five-yr-old boy with PFIC1 employing EBD after re-transplantation. The patient received LDLT at the age of one yr. Six months after initial transplantation, he developed repeated attacks and diarrhea followed by the development of liver dysfunction and ascites. Liver biopsy at three yr after LDLT revealed the features of chronic graft rejection. With a diagnosis of chronic graft rejection with liver failure, we performed a repeat LDLT with EBD in which the jejunal loop used for hepaticojejunostomy was taken out of the body surface through the abdominal wall. Ten months after surgery, he is doing well, having no attack of diarrhea.
authors.affiliation: Department of Hepatobiliary Pancreatic Surgery, Mie University, Tsu, Mie, Japan. m-usui@clin.medic.mie-u.ac.jp
authors.forename: Masanobu
authors.initials: M
authors.lastname: Usui
authors.forename: Shuji
authors.initials: S
authors.lastname: Isaji
authors.forename: Bidhan C
authors.initials: BC
authors.lastname: Das
authors.forename: Motoyuki
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Ichiro
authors.initials: I
authors.lastname: Osawa
authors.forename: Taku
authors.initials: T
authors.lastname: Iida
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Sakurai
authors.forename: Masami
authors.initials: M
authors.lastname: Tabata
authors.forename: Toru
authors.initials: T
authors.lastname: Yorifuji
authors.forename: Hiroto
authors.initials: H
authors.lastname: Egawa
authors.forename: Shinji
authors.initials: S
authors.lastname: Uemoto
mesh_terms: D001662:Biliary Tract Surgical Procedures / Q000379:methods; D001706:Biopsy; D002779:Cholestasis / Q000601:surgery; D002780:Cholestasis, Intrahepatic / Q000235:genetics / Q000628:therapy*; D018450:Disease Progression; D006801:Humans; D007223:Infant; D008099:Liver / Q000601:surgery; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D012086:Reoperation; D013997:Time Factors; D016896:Treatment Outcome