Living Donor Re-transplantation for Repeated Acute Liver Failure

Area of Science:

• Hepatology
• Transplantation Medicine
• Gastroenterology

Background:

• Acute liver failure (ALF) necessitates emergency liver transplantation (LT) as a life-saving intervention.
• Recurrent ALF in the same patient is exceptionally rare.
• Living donor liver transplantation (LDLT) offers a viable solution for ALF.

Observation:

• A 26-year-old patient experienced ALF due to herbal supplements, requiring an emergency right lobe LDLT from her sister.
• Three years later, during the 37th week of pregnancy, the patient developed a second episode of ALF.
• Despite medical management and cesarean delivery, liver function deteriorated, necessitating a second emergency LDLT.

Findings:

• The patient received a second right lobe LDLT, this time from her brother.
• Both the patient and her newborn infant recovered well, with a positive 2-month follow-up.
• This represents a unique case of a patient undergoing two LDLTs for separate ALF events.

Implications:

• The successful outcome underscores the efficacy of LDLT in managing both primary and secondary ALF.
• This case expands the understanding of LDLT applicability in complex, recurrent liver failure scenarios.
• LDLT is presented as a paramount treatment option for patients with repeated episodes of acute liver failure.