title: Seventh-day syndrome: a catastrophic event after liver transplantation: case report.
abstract: Seventh-day syndrome (7DS) is an early serious complication of liver transplantation, characterized by sudden failure of a previously normally functioning liver graft ∼1 week after the surgery. Although it is an uncommon event, it has major associated mortality. As its etiology is yet to be recognized, the only currently available treatment is retransplantation. We present 3 cases of orthotopic liver transplantation recipients who had an initial uneventful recovery after surgery followed by a dramatic rise of serum liver enzyme levels ∼7 days later and hepatic failure with subsequent graft loss and death despite high-dose immunosuppressive therapy. Histologic findings showed massive centrolobular hemorrhage and hepatocellular necrosis with reduced inflammation. It is essential to review and accumulate more clinical and laboratory information to better understand this syndrome and to better prevent and treat it.
authors.affiliation: Liver and Pancreas Transplantation Unit, Centro Hospitalar do Porto, Porto, Portugal. Electronic address: martabarpereira@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Pereira
authors.affiliation: Liver and Pancreas Transplantation Unit, Centro Hospitalar do Porto, Porto, Portugal.
authors.forename: I
authors.initials: I
authors.lastname: Ferreira
authors.affiliation: Liver and Pancreas Transplantation Unit, Centro Hospitalar do Porto, Porto, Portugal.
authors.forename: J
authors.initials: J
authors.lastname: Gandara
authors.affiliation: Liver and Pancreas Transplantation Unit, Centro Hospitalar do Porto, Porto, Portugal.
authors.forename: S
authors.initials: S
authors.lastname: Ferreira
authors.affiliation: Liver and Pancreas Transplantation Unit, Centro Hospitalar do Porto, Porto, Portugal.
authors.forename: V
authors.initials: V
authors.lastname: Lopes
authors.affiliation: Anatomic Pathology Department, Centro Hospitalar do Porto, Porto, Portugal.
authors.forename: A
authors.initials: A
authors.lastname: Coelho
authors.affiliation: Anatomic Pathology Department, Centro Hospitalar do Porto, Porto, Portugal.
authors.forename: R
authors.initials: R
authors.lastname: Vizcaino
authors.affiliation: Intensive Care Unit, Centro Hospitalar do Porto, Portugal.
authors.forename: A
authors.initials: A
authors.lastname: Marinho
authors.affiliation: Liver and Pancreas Transplantation Unit, Centro Hospitalar do Porto, Porto, Portugal.
authors.forename: J
authors.initials: J
authors.lastname: Daniel
authors.affiliation: Liver and Pancreas Transplantation Unit, Centro Hospitalar do Porto, Porto, Portugal.
authors.forename: H P
authors.initials: HP
authors.lastname: Miranda
mesh_terms: D000293:Adolescent; D001706:Biopsy; D004796:Clinical Enzyme Tests; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D017093:Liver Failure / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D013577:Syndrome; D018608:Ultrasonography, Doppler