Transplantation of a severely lacerated liver--a case report with review of the literature.

Abstract:

:Using lacerated livers for liver transplantation (LTx) can add an option to the extended donor criteria. We present an LTx case using a severely lacerated liver and review of the literature for reported cases. We used a high-grade lacerated liver from a 19-yr-old brain-dead patient caused by traffic accident. The liver had grade IV and II lacerations in the right and left lobe, respectively. Lacerations were managed by sealants, stitching and perihepatic packing. The liver was transplanted to a 49-yr-old man suffering from hepatocellular carcinoma on hepatitis C-induced liver cirrhosis. The two-yr follow-up was uneventful. All published LTx cases using traumatized livers (n = 18) were analyzed. The liver injury ranged from subcapsular hematoma to deep ruptures. Most reported lacerations were in the right lobe, which were managed by digital compression, suturing, electrocautery, and perihepatic packing. The reported complications were primary non- (18%), or poor function, liver abscess, bilioma, and subhepatic hematoma each in one case (5.5%). Six-month graft and patient survival were 71% and 88%, respectively. With meticulous management lacerated livers can be transplanted successfully. Because of complexity of the management, procurement and transplantation should be done by experienced liver surgeons. These organs are marginal grafts and should be offered to selected patients.

journal_name

Clin Transplant

journal_title

Clinical transplantation

authors

Mehrabi A,Fonouni H,Ahmadi R,Schmied BM,Müller SA,Welsch T,Hallscheidt P,Zeier M,Weitz J,Schmidt J

doi

10.1111/j.1399-0012.2008.00914.x

subject

Has Abstract

pub_date

2009-06-01 00:00:00

pages

321-8

issue

3

eissn

0902-0063

issn

1399-0012

journal_volume

23

pub_type

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