title: A survival case of severe liver failure caused by acetylsalicylic acid that was treated with living donor liver transplantation.
abstract: BACKGROUND
  Severe liver dysfunction caused by acetylsalicylic acid (ASA) is quite rare. The purpose is to describe a patient with severe liver dysfunction due to excessive intake of ASA in a suicide attempt, who was successfully treated with living donor liver transplantation (LDLT).
  
  
  METHODS
  We report a 20-year-old woman who took 66 g of ASA in a suicide attempt. She was admitted to our hospital and received forced alkaline diuresis. However, her liver and renal functions worsened after admission. On the 6th day after intake of ASA, she was transferred to the intensive care unit, and plasma exchange (PE) and continuous hemodiafiltration were performed. Since her liver function did not recover despite repeated PE, she was transferred to another hospital for LDLT on the 8th day. She underwent LDLT with a portion of the liver donated from her mother on the 11(th) day. After the operation, her renal dysfunction continued. Her renal parameters gradually improved, and she was discharged on the 44th post-operative day without renal dysfunction.
  
  
  CONCLUSIONS
  PE is effective in removing ASA from blood. Liver transplantation is the only effective treatment if liver function does not recover in spite of repeated PE.
authors.affiliation: Department of Emergency Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Hagiwara
authors.affiliation: Department of Emergency Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Kaneko
authors.affiliation: Department of Emergency Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Murata
authors.affiliation: Department of Transplantation Surgery, Shinshu University Hospital, Matumoto, Nagano, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Ikegami
authors.affiliation: Department of Emergency Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Oshima
keywords: Toxicosis; acetylsalicylic acid; liver dysfunction; liver transplantation