Treatment of liver transplantation on acute liver failure of pregnancy:a report of two cases and literature review / 器官移植

ABSTRACT

Objective To investigate the curative effect of liver transplantation on acute liver failure of pregnancy.Methods Clinical data of 2 patients with acute liver failure of pregnancy undergoing liver transplantation in the Third Affiliated Hospital of Sun Yat-sen University from March 2004 to June 201 5 were retrospectively studied.Results The patient of case 1 developed subacute liver failure and underwent emergency liver transplantation,because chronic viral hepatitis B (HBV)progressed quickly after natural delivery.The patient of case 2 developed acute liver failure with unknown etiology,and underwent subtotal hysterectomy by the obstetrician on the following day of emergency liver transplantation because the intrauterine fetus was dead. The two patients were given tacrolimus (FK506 ) and adrenocortical hormone as the postoperative early immunosuppressive regimen.Anti-HBV treatment was enhanced for the patient of case 1 with the antivirus regimen of entecavir combined with hepatitis B immune globulin.The patient of case 1 was willing to continue pregnancy,so the minimal dose of a single immunosuppressant was used when the graft function was stable.The patient of case 2 had no ability of pregnancy and underwent routine postoperative management.The two patients were followed up till the date of submission and they recovered well.The patient of case 1 had no recurrence of HBV and delivered a baby boy successfully.Conclusions Liver transplantation on acute liver failure of pregnancy may obtain good curative effect.