Transplantation of a severely lacerated liver - A case report with review of the literature

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Arianeb Mehrabi - , Heidelberg University  (Author)
  • Hamidreza Fonouni - , Heidelberg University  (Author)
  • Rezvan Ahmadi - , Heidelberg University  (Author)
  • Bruno M. Schmied - , Heidelberg University  (Author)
  • Sascha A. Müller - , Heidelberg University  (Author)
  • Thilo Welsch - , Heidelberg University  (Author)
  • Peter Hallscheidt - , Heidelberg University  (Author)
  • Martin Zeier - , Heidelberg University  (Author)
  • Jürgen Weitz - , Heidelberg University  (Author)
  • Jan Schmidt - , Heidelberg University  (Author)

Abstract

Using lacerated livers for liver transplantation (LTx) can add an option to the extended donor criteria. We present an LTx case using a severely lacerated liver and review of the literature for reported cases. We used a high-grade lacerated liver from a 19-yr-old brain-dead patient caused by traffic accident. The liver had grade IV and II lacerations in the right and left lobe, respectively. Lacerations were managed by sealants, stitching and perihepatic packing. The liver was transplanted to a 49-yr-old man suffering from hepatocellular carcinoma on hepatitis C-induced liver cirrhosis. The two-yr follow-up was uneventful. All published LTx cases using traumatized livers (n = 18) were analyzed. The liver injury ranged from subcapsular hematoma to deep ruptures. Most reported lacerations were in the right lobe, which were managed by digital compression, suturing, electrocautery, and perihepatic packing. The reported complications were primary non-(18%), or poor function, liver abscess, bilioma, and subhepatic hematoma each in one case (5.5%). Six-month graft and patient survival were 71% and 88%, respectively. With meticulous management lacerated livers can be transplanted successfully. Because of complexity of the management, procurement and transplantation should be done by experienced liver surgeons. These organs are marginal grafts and should be offered to selected patients.

Details

Original languageEnglish
Pages (from-to)321-328
Number of pages8
JournalClinical Transplantation
Volume23
Issue number3
Publication statusPublished - 2009
Peer-reviewedYes
Externally publishedYes

External IDs

PubMed 19537300

Keywords

Sustainable Development Goals

ASJC Scopus subject areas

Keywords

  • Lacerated liver, Liver transplantation, Liver trauma