Adult Living Donor Liver Re-Transplant Following Late Pediatric Liver Transplant Failure: A Case Report

BACKGROUND Re-transplant of a late failing living donor liver graft using another graft from another living donor is a rare occurrence and is associated with high mortality due to the complexity of the procedure. There are only a few such case series reported in the literature, mainly from South Asi...

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Bibliographic Details
Published in:The American journal of case reports 2019-06, Vol.20, p.908-913
Main Authors: Al Bahili, Hamad, Al Garni, Abdullah, Al Hasan, Ibrahim, Alsebayel, Yazeed M, Al Eid, Maha, Al Zaharani, Ahmed, Qahtani, Awad Salem, Negmi, Hisham H, Al Masri, Nasser
Format: Article
Language:English
Subjects:
Adult
Cholangitis, Sclerosing - surgery
End Stage Liver Disease - surgery
Graft Rejection - surgery
Graft Survival
Humans
Liver Transplantation
Living Donors
Male
Reoperation
Risk Factors
Severity of Illness Index
Treatment Outcome
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Summary:BACKGROUND Re-transplant of a late failing living donor liver graft using another graft from another living donor is a rare occurrence and is associated with high mortality due to the complexity of the procedure. There are only a few such case series reported in the literature, mainly from South Asia and Japan, where living donor liver transplant is commonly performed, and there are no such reports from Western countries. CASE REPORT This is a case of living donor liver re-transplant for a 28-year-old recipient whose graft failed 14 years after his primary living donor transplant for primary sclerosing cholangitis. The second transplant was a right-lobe graft obtained from a living donor. The presence of portal vein thrombosis in the setting of high Model for End-Stage Liver Disease (MELD) score added to the complexity of the case. The procedure was concluded successfully with an uneventful post-operative course. The patient was discharged 3 weeks after the procedure. One-year follow-up showed a normally functioning graft. CONCLUSIONS Successfully re-transplanting a patient with a failing living donor liver graft from a living donor is possible if sufficient surgical expertise is available and the risk and benefit are carefully considered. This is especially important in countries where a cadaveric graft is difficult to obtain due to organ scarcity.
ISSN:1941-5923
1941-5923
DOI:10.12659/AJCR.914456