Acute Antibody-Mediated Rejection as Cause of Late Liver Allograft Failure: A Case Report

Despite now being an infrequent complication in liver transplantation (LT) recipients, acute liver failure is still associated with high mortality.

Here we report a case of acute liver failure 11 months after AB0-compatible LT in a hepatitis C-positive 50-year-old male recipient caused by late antibody-mediated rejection (AMR). De novo donor-specific antibodies appeared later in a previously negative donor-recipient crossmatch, leading to a rapid deterioration of liver function.

We highlight the importance of an accurate diagnosis and an early therapeutic intervention. The analysis of this case brings novel and generalizable insights to the differential diagnosis of acute liver failure after LT.