Total hepatectomy and liver transplantation as a two-stage procedure for fulminant hepatic failure: A safe procedure in exceptional circumstances

Table 1 Transplant details and patient survival

	Sex, age	Indication	MELD	Toxic liver syndrome	CVVH	Hptc before graft availability	Inotrope requirements	Anhepatic phase (h)	Survival (mo)
1	F, 26	Paracetamol overdose	39	Yes	No	Yes	Yes	7	116
2	M, 41	Heat stroke	40	Yes	Yes	Yes	Yes	16	22
3	M, 47	Fulminant hepatits A	40	Yes	Yes	No	Yes	5.5	12 h
4	M, 20	Paracetamol overdose	40	Yes	No	No	No	5.8	107
5	F, 30	Paracetamol overdose	36	Yes	Yes	Yes	Yes	44	108
6	M, 21	Liver trauma	28	No	No	Yes	No	15	106

MELD: Model end stage liver disease; CVVH: Continous venoveno hemodyalisis; Hptc: Hepatectomy.

Table 2 Biochemical data pre and post transplant

No. of patient		Dose NA	pH	Bicarbonate (mmol/L)	Lactate (mmol/L)	INR	Sodium (mmol/L)	Potasium (mmol/L)
	Before Hptc	70	7.14	11.30	5.32	11.25	133	3.9
1	Anhepatic	80	7.24	17.20	7.3	2.50	133	3.7
	Post reperfusion	60	7.27	16.40	6	1.85	135	5.4
	Before Hptc	64	7.15	13.30	9.20	15.80	136	5.5
2	Anhepatic	80	7.26	14.00	11	3.33	137	4.5
	Post reperfusion	20	7.20	14.60	10	2.27	145	3.9
	Before Hptc	50	7.06	14.70	10.20	13	138	4.8
3	Anhepatic	36	7.17	13.30	10	1.75	143	4.9
	Post reperfusion	48	7.12	13.80	10.5	1.75	146	5.0
	Before Hptc	None	7.34	11.10	5.30	17	133	3.6
4	Anhepatic	10	7.34	20.70	4.20	2.90	133	3.6
	Post reperfusion	5	7.32	18.60	3.7	1.64	136	3.8
	Before Hptc	200	7.16	11.30	12.00	6.3	148	3.7
5	Anhepatic	68	7.26	18.00	12.30	3.01	141	4.2
	Post reperfusion	32	7.19	14.00	6.7	2.47	144	5.20
	Before Hptc	None	7.02	10.70	3.30	10.59	151	5.0
6	Anhepatic	120	6.91	13.50	7.7	2.46	146	4.3
	Post reperfusion	10	7.01	12.70	7.7	1.61	144	3.8
	Before Hptc	67	7.14	11.3	7.26	12.12	137	4.35
		(50-200)	(7.02-7.34)	(10.70-14.7)	(3.3-12)	(6.3-17)	(133-152)	(3.6-5.5)
Median	Anhepatic	74	7.25	15.6	8.85	2.7	139	4.3
range		(10-120)	(6.91-7.34)	(13.30-20.70)	(4.2-12.3)	(1.75-3.33)	(133-146)	(3.6-4.9)
	Post reperfusion	26	7.19	14.3	14.3	1.8	144	4.45
		(5-60)	(7.01-7.32)	(12.7-18.60)	(12.7-18.60)	(1.61-2.47)	(135-146)	(3.8-5.4)

INR: International normalized ratio; pH: Potential of hydrogen; NA: Noradrenaline; Hptc: Hepatectomy.