Long-term survival after 67 hours of anhepatic state due to primary liver allograft nonfunction.
Primary liver allograft nonfunction immediately after transplantation poses a life-threatening situation for the recipient. Emergency retransplantation may not be immediately possible due to organ unavailability. Total hepatectomy with temporary portacaval shunt has been described as a bridge to retransplantation when the presence of the graft appears to be harming the recipient. Case reports of retransplantation after total hepatectomy with anhepatic times greater than 48 hours routinely describe poor outcomes. We present a case with excellent patient outcome after 95 hours of clinical anhepatic state, including 67 hours of anatomical anhepatic time, because of primary liver allograft nonfunction. This case report documents the longest anhepatic time with subsequent successful transplant to date.
Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7211, USA.
Harendra
H
Arora
Janine
J
Thekkekandam
Leora
L
Tesche
Raeshell
R
Sweeting
David A
DA
Gerber
Paul H
PH
Hayashi
Kenneth
K
Andreoni
Tomasz
T
Kozlowski
D000328:Adult; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008099:Liver / Q000503:physiopathology* / Q000601:surgery; D008107:Liver Diseases / Q000601:surgery*; D016031:Liver Transplantation / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D017741:Survivors; D013997:Time Factors; D014184:Transplantation, Homologous; D016896:Treatment Outcome