title: Retrospective observation of therapeutic effects of adult auxiliary partial living donor liver transplantation on postpartum acute liver failure: a case report.
abstract: We present a female patient with preterm labor, severe viral hepatitis B of acute phase, hepatic encephalopathy stage III and coma. After delivery, the illness was exacerbated and the patient presented with clinical signs of vital organ dysfunctions such as acute respiratory distress syndrome, cerebral edema and hypoxemia that needed mechanical ventilation. Emergency liver transplantation was recommended after multidisciplinary panel consultations. The donor, her mother, consented to donate her right liver. Auxiliary partial orthotopic living donor liver transplantion (APOLDLT) was performed. After operation, the patient was on triple medication of tacrolimus plus mofetil mycophenolate and prednisone for immunosuppression. The combination of anti-hepatitis B virus (HBV) immunoglobulin and entecavir was initiated for anti-HBV therapy. Both the patient and the donor recovered well without any complications. The patient was followed up regularly. Her liver function, clinical signs and symptoms improved significantly. Until now, the recipient has been living for more than 78 mo free of any complications. The APOLDLT is a life-saving modality for rescuing patients with high-risk acute liver failure following HBV infection without available donor and hence is recommended under standardized antiviral therapy coverage as stated above.
authors.affiliation: Chuan-Yun Li, Department of Hepatobiliary Surgery and Liver Transplantation Center, Beijing You-An Hospital, Capital Medical University, Beijing 100069, China.
authors.forename: Chuan-Yun
authors.initials: CY
authors.lastname: Li
authors.affiliation: Chuan-Yun Li, Department of Hepatobiliary Surgery and Liver Transplantation Center, Beijing You-An Hospital, Capital Medical University, Beijing 100069, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Lai
authors.affiliation: Chuan-Yun Li, Department of Hepatobiliary Surgery and Liver Transplantation Center, Beijing You-An Hospital, Capital Medical University, Beijing 100069, China.
authors.forename: Shi-Chun
authors.initials: SC
authors.lastname: Lu
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D001706:Biopsy; D018450:Disease Progression; D005260:Female; D006509:Hepatitis B / Q000175:diagnosis / Q000601:surgery* / Q000821:virology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D017114:Liver Failure, Acute / Q000175:diagnosis / Q000601:surgery* / Q000821:virology; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D007752:Obstetric Labor, Premature / Q000175:diagnosis / Q000821:virology*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000601:surgery* / Q000821:virology; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D007166:Immunosuppressive Agents
keywords: Acute liver failure; Anti-hepatitis B virus immunoglobulin; Auxiliary partial orthotopic living donor liver transplant; Entecavir; Hepatitis B virus; Postpartum