title: Successful salvage delivery and liver transplantation for fulminant hepatic failure in a 34-week pregnant woman: a case report.
abstract: We report the case of a 40-year-old multiparous woman with fulminant hepatic failure due to acute hepatitis B virus infection who underwent a successful cesarean delivery of a healthy male fetus at 34 weeks, gestation and a few hours thereafter successful salvage orthotopic liver transplantation (OLT). There were no obstetric complications; the neonatal outcome was excellent. At 27 months, follow-up, the patient is doing well, and the newborn exhibits normal development. OLT for acute liver failure during pregnancy is an uncommon occurrence with variable outcomes. This case illustrates the challenge of treating this rare condition and demonstrates that a salvage double surgical approach-emergency delivery and OLT-is a feasible therapeutic option for treatment of these patients.
authors.affiliation: Department of General Visceral and Transplantation Surgery, University Hospital Essen, Essen, Germany. svernadakis@yahoo.com
authors.forename: S
authors.initials: S
authors.lastname: Vernadakis
authors.forename: I
authors.initials: I
authors.lastname: Fouzas
authors.forename: S
authors.initials: S
authors.lastname: Kykalos
authors.forename: G M
authors.initials: GM
authors.lastname: Kaiser
authors.forename: M
authors.initials: M
authors.lastname: Metzelder
authors.forename: A
authors.initials: A
authors.lastname: Paul
authors.forename: G C
authors.initials: GC
authors.lastname: Sotiropoulos
mesh_terms: D000208:Acute Disease; D000328:Adult; D002585:Cesarean Section; D005260:Female; D005865:Gestational Age; D006509:Hepatitis B / Q000150:complications / Q000175:diagnosis / Q000601:surgery* / Q000821:virology; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D017114:Liver Failure, Acute / Q000175:diagnosis / Q000601:surgery* / Q000821:virology; D016031:Liver Transplantation; D008297:Male; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000601:surgery* / Q000821:virology; D047928:Premature Birth; D013997:Time Factors; D016896:Treatment Outcome