Case Report
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World J Gastroenterol. Feb 14, 2013; 19(6): 964-967
Published online Feb 14, 2013. doi: 10.3748/wjg.v19.i6.964
Severe hepatic necrosis of unknown causes following ABO-incompatible liver transplantation
Hao Lu, Chuan-Yong Zhang, Wei Ding, Yun-Jie Lu, Guo-Qiang Li, Feng Zhang, Ling Lu
Hao Lu, Chuan-Yong Zhang, Wei Ding, Yun-Jie Lu, Guo-Qiang Li, Feng Zhang, Ling Lu, Liver Transplantation Center, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
Author contributions: Lu H, Zhang CY and Ding W contributed equally to this work; Zhang F and Lu L designed the research; Ding W and Lu YJ analyzed the data; Zhang CY, Li GQ and Zhang F performed the operation; and Lu H and Ding W wrote the paper.
Correspondence to: Ling Lu, MD, PhD, Liver Transplantation Center, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China. lvling@njmu.edu.cn
Telephone: +86-25-83672106 Fax: +86-25-83672106
Received: October 17, 2012
Revised: December 29, 2012
Accepted: January 11, 2013
Published online: February 14, 2013
Processing time: 123 Days and 16.4 Hours
Abstract

Emergency ABO-incompatible (ABO-I) liver transplantations (LTx) have been performed increasingly to treat severe liver failure. Herein, we report a case of severe hepatic necrosis after ABO-I LTx. A 53-year-old man with blood group O was diagnosed as having severe hepatitis B and acute-on-chronic liver failure, and underwent an emergency liver transplantation implanting a blood-group-B liver from a cardiac-death donor. A routine anti-rejection, anti-infection and anti-virus therapy was given after operation. On post-operative day (POD) 16, the recipient had fever and erythra. Laboratory and radiographic examinations suggested a severe hepatic necrosis of unknown causes. The patient was managed with a 10-d methylprednisolone pulse therapy. He was discharged on POD 35 with stable condition, and no recurrent disease was found during the follow-up.

Keywords: Liver transplantations; ABO-incompatible; Hepatic necrosis; Graft rejection; Pulse therapy