Logo Annals of Transplantation Logo Annals of Transplantation Logo Annals of Transplantation

21 February 2014 : Case report  

Long-term survival after 66 hours of anhepatic time with no neurological deficit

Evangelos PhotiEF, Michael CrawfordBE, Carlo PulitanoDE

DOI: 10.12659/AOT.889604

Ann Transplant 2014; 19:93-95


Background: Intractable intraoperative hemorrhage is a rare complication of liver transplantation. Rescue hepatectomy with portocaval shunting can be used as a bridging procedure until a new organ donor becomes available. During the anhepatic period, however, there is a substantial risk of developing end-organ damage, the brain being particularly susceptible to insult.
Case Report: A 66-year-old male underwent liver transplantation due to non-alcoholic steatotic hepatitis and hepatocellular carcinoma. The transplantation was complicated by perioperative intractable bleeding. Despite attempts to control the bleeding, the patient became hemodynamically unstable and a rescue hepatectomy with portocaval shunting was performed. The patient remained anhepatic for 66 hours in an intensive care unit until a second donor organ was found. He made a good recovery and had no neurological deficit.
Conclusions: Rescue hepatectomy with portocaval shunting is a viable short-term solution until a suitable donor organ is found. During this period, inotrope infusion and continuous veno-venous hemofiltration within an intensive care unit setting can be used as supportive measures. Nevertheless, a prolonged anhepatic time increases the risk of multiple organ failure and should be kept to a minimum due to metabolic disturbance and the build-up of toxic metabolites.

Keywords: Transplantation, Rescue hepatectomy, portocaval shunt, Anhepatic

Add Comment 0 Comments

In Press

Original article  

Post-Donation Regret and Anxiety Among Family Living Liver Donors: The Mediating Roles of Family Relationsh...

Ann Transplant In Press; DOI: 10.12659/AOT.944176  

Original article  

Effect of the Organ Donation Quality System on Donation Activity of Warsaw Hospitals

Ann Transplant In Press; DOI: 10.12659/AOT.943520  

Original article  

Clonal Hematopoiesis-Associated Gene Mutations Affect Acute Graft-Versus-Host Disease After Hematopoietic S...

Ann Transplant In Press; DOI: 10.12659/AOT.943688  

Original article  

Impact of Recipient and Donor Body Mass Index on Survival Outcomes After Intestinal Transplantation: A Unit...

Ann Transplant In Press; DOI: 10.12659/AOT.943994  

Most Viewed Current Articles

05 Apr 2022 : Original article   12,171

Impact of Statins on Hepatocellular Carcinoma Recurrence After Living-Donor Liver Transplantation

DOI :10.12659/AOT.935604

Ann Transplant 2022; 27:e935604

12 Jan 2022 : Original article   8,611

Risk Factors for Developing BK Virus-Associated Nephropathy: A Single-Center Retrospective Cohort Study of ...

DOI :10.12659/AOT.934738

Ann Transplant 2022; 27:e934738

22 Nov 2022 : Original article   8,587

Long-Term Effects of Everolimus-Facilitated Tacrolimus Reduction in Living-Donor Liver Transplant Recipient...

DOI :10.12659/AOT.937988

Ann Transplant 2022; 27:e937988

15 Mar 2022 : Case report   6,458

Combined Liver, Pancreas-Duodenum, and Kidney Transplantation for Patients with Hepatitis B Cirrhosis, Urem...

DOI :10.12659/AOT.935860

Ann Transplant 2022; 27:e935860

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358