title: Successful living donor liver transplantation for acute liver failure after acetylsalicylic acid overdose.
abstract: A 20-year-old woman was admitted to an emergency hospital after ingesting 66 g of acetylsalicylic acid in a suicide attempt. Although she was treated with gastric lavage, oral activated charcoal, and intravenous hydration with sodium bicarbonate, her hepatic and renal function gradually deteriorated and serum amylase levels increased. Steroid pulse therapy, plasma exchange, and continuous hemodiafiltration did not yield any improvement in her hepatic or renal function, and she was transferred to our hospital for living donor liver transplantation. Nine days after drug ingestion, she developed hepatic encephalopathy: thus, we diagnosed the patient with acute liver failure with hepatic coma accompanied by acute pancreatitis due to the overdose of acetylsalicylic acid. Living donor liver transplantation was immediately performed using a left lobe graft from the patient's mother. Following transplantation, the patient's renal and hepatic function and consciousness improved, and she was discharged. In this report, we describe a rare case of acetylsalicylic acid-induced acute liver failure with acute hepatic coma and concomitant acute pancreatitis and acute renal failure, which were treated successfully with emergency living donor liver transplantation.
authors.affiliation: First Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621, Japan, but_ibshigin@live.jp.
authors.forename: Tomoki
authors.initials: T
authors.lastname: Shirota
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Ikegami
authors.forename: Satoshi
authors.initials: S
authors.lastname: Sugiyama
authors.forename: Kouji
authors.initials: K
authors.lastname: Kubota
authors.forename: Akira
authors.initials: A
authors.lastname: Shimizu
authors.forename: Yasunari
authors.initials: Y
authors.lastname: Ohno
authors.forename: Atsuyoshi
authors.initials: A
authors.lastname: Mita
authors.forename: Koichi
authors.initials: K
authors.lastname: Urata
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Nakazawa
authors.forename: Akira
authors.initials: A
authors.lastname: Kobayashi
authors.forename: Mai
authors.initials: M
authors.lastname: Iwaya
authors.forename: Shinichi
authors.initials: S
authors.lastname: Miyagawa
mesh_terms: D000208:Acute Disease; D058186:Acute Kidney Injury / Q000139:chemically induced; D001241:Aspirin / Q000506:poisoning*; D062787:Drug Overdose / Q000150:complications*; D005260:Female; D006501:Hepatic Encephalopathy / Q000139:chemically induced; D006801:Humans; D017114:Liver Failure, Acute / Q000139:chemically induced* / Q000601:surgery*; D016031:Liver Transplantation; D019520:Living Donors; D010195:Pancreatitis / Q000139:chemically induced; D013406:Suicide, Attempted; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D001241:Aspirin