title: Successful living donor liver transplantation for fulminant hepatic failure that manifested immediately after cesarean delivery.
abstract: A 31-year-old pregnant woman was diagnosed as having acute hepatitis of unknown etiology and conservatively treated. An emergency cesarean delivery was performed 5 days later at 33 weeks and 3 days of gestation because of a gradual deterioration in liver function. Two days after the cesarean delivery, she lost consciousness in the evening (Glasgow coma scale [GCS] = 9) because of hepatic encephalopathy and was diagnosed as having fulminant hepatic failure (FHF). Five days after the cesarean delivery, the patient (blood type B) underwent a successful left lobe with caudate lobe (S1+2+3+4) liver transplantation from her father (blood type AB), an ABO-incompatible donor. At 1 year follow-up, she and her baby are in good medical condition. The drastic deterioration in hepatic function, despite intensive plasmapheresis and continuous hemodiafiltration, during the early postpartum period suggested a possible causative association between the termination of pregnancy and progression of FHF from acute hepatitis of unknown etiology.
authors.affiliation: Department of Obstetrics and Gynecology, Hamamatsu University School of Medicine, Japan.
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Horikoshi
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Itoh
authors.forename: Suguru
authors.initials: S
authors.lastname: Kikuchi
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Uchida
authors.forename: Kazunao
authors.initials: K
authors.lastname: Suzuki
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Sugihara
authors.forename: Naohiro
authors.initials: N
authors.lastname: Kanayama
authors.forename: Akira
authors.initials: A
authors.lastname: Mori
authors.forename: Shinji
authors.initials: S
authors.lastname: Uemoto
mesh_terms: D000328:Adult; D002585:Cesarean Section; D005260:Female; D006501:Hepatic Encephalopathy / Q000209:etiology / Q000601:surgery; D006505:Hepatitis / Q000150:complications / Q000601:surgery; D006801:Humans; D017114:Liver Failure, Acute / Q000209:etiology / Q000601:surgery*; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000601:surgery*