Fatal Herpes Simplex Hepatitis in a Live Liver Donor

Area of Science:

• Hepatology
• Infectious Diseases
• Transplantation Immunology

Background:

• Living donor liver transplantation (LDLT) is a critical procedure for end-stage liver disease.
• Donor safety is paramount, yet rare complications can occur post-hepatectomy.
• Acute liver failure (ALF) post-donor hepatectomy necessitates a broad differential diagnosis.

Observation:

• A case of a living liver donor experiencing fatal Herpes simplex hepatitis (HSV hepatitis) following hepatectomy is reported.
• The patient presented with symptoms indicative of acute liver failure.
• Diagnosis was confirmed as HSV hepatitis, a rare but severe post-operative complication.

Findings:

• Herpes simplex hepatitis can be a cause of acute liver failure in the post-operative period for living liver donors.
• Delayed recognition and treatment of HSV hepatitis can lead to catastrophic outcomes.
• This case underscores the importance of considering uncommon infectious etiologies in post-hepatectomy ALF.

Implications:

• Vigilance for rare, treatable causes of ALF, such as HSV hepatitis, is essential in living liver donors.
• Early suspicion and prompt initiation of antiviral therapy (e.g., acyclovir) may improve survival rates.
• This case highlights the need for updated protocols and awareness regarding infectious complications in LDLT donors.