Severe hepatic necrosis of unknown causes following ABO-incompatible liver transplantation

Figure 3 Total bilirubin and creatine, liver function, prothrombin time and international normalized ratio changes after liver transplantation. A: Total bilirubin (TBIL) and creatine (Cr) levels elevated after graft implantation and then decreased in 2 wk. Severe hepatic necrosis resulted in a slight rise, which was reversed by methylprednisolone(MP) pulse therapy; B:Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) dropped significantly within 5 d after liver transplantation (LTx), and then remained in a low level till post-operative day (POD) 16. Severe hepatic necrosis led to a sharp increase of both ALT and AST which were under control after 4-d intravenous drip of 500 mg MP. Dosage of MP was reduced gradually to 40 mg on POD 25; C: Prothrombin time (PT) and international normalized ratio (INR) changes after LTx. Coagulation function became normal within 5 d. HN: Hepatic necrosis.