Case Report
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Apr 7, 2009; 15(13): 1641-1644
Published online Apr 7, 2009. doi: 10.3748/wjg.15.1641
Liver transplantation for severe hepatic trauma: Experience from a single center
Spiros G Delis, Andreas Bakoyiannis, Gennaro Selvaggi, Debbie Weppler, David Levi, Andreas G Tzakis
Spiros G Delis, Andreas Bakoyiannis, Gennaro Selvaggi, Debbie Weppler, David Levi, Andreas G Tzakis, Department of Surgery, Division of Transplantation, University of Miami Miller School of Medicine, PO Box 012440 (R440), Miami, Florida 33101, United States
Author contributions: Delis SG, Selvaggi G, Weppler D and Levi D designed and performed the research; Delis SG, Selvaggi G, Weppler D and Tzakis AG analyzed the data; Delis SG wrote the paper; Bakoyiannis A reviewed the literature; Tzakis AG supervised the work.
Correspondence to: Spiros G Delis, MD, PhD, Department of Surgery, Division of Transplantation, University of Miami Miller School of Medicine, PO Box 012440 (R440), Miami, Florida 33101, United States. sdelis55@hotmail.com
Telephone: +1-305-3555111
Fax: +1-305-3555134
Received: November 16, 2008
Revised: March 4, 2009
Accepted: March 11, 2009
Published online: April 7, 2009
Abstract

Liver transplantation has been reported in the literature as an extreme intervention in cases of severe and complicated hepatic trauma. The main indications for liver transplant in such cases were uncontrollable bleeding and postoperative hepatic insufficiency. We here describe four cases of orthotopic liver transplantation after penetrating or blunt liver trauma. The indications were liver failure, extended liver necrosis, liver gangrene and multiple episodes of gastrointestinal bleeding related to portal hypertension, respectively. One patient died due to postoperative cerebral edema. The other three patients recovered well and remain on immunosuppression. Liver transplantation should be considered as a saving procedure in severe hepatic trauma, when all other treatment modalities fail.

Keywords: Liver injury; Orthotopic liver transplantation; Severe liver trauma; Hepatic coma; Hepatic trauma