RESUMEN
Fascioliasis is caused by the trematode liver fluke Fasciola hepatica. Humans are accidental hosts getting infected after ingesting contaminated plants or water. 90 million people in 75 nations are at risk of infection with F hepatica. Immunosuppressed patients are higher risk of acquiring infection and may present with atypical manifestations. Patients can present with hepatic involvement, biliary features or a combination of both. Confirmation of the diagnosis is by demonstration of live parasites or eggs in bile or feces, serology (immunoelectrophoresis, indirect immunofluorescence, indirect hemagglutination), ELISA, typical imaging findings or a combination of any of the above. The drug of choice for treatment is triclabendazole. Fascioliasis should always be considered as a possibility in post-LT patients with findings of hepatobiliary disorder from endemic areas. Unfamiliarity with this infection in non-endemic areas often eludes prompt diagnosis thereby increasing the morbidity. We report the first case of fascioliasis in a pediatric liver transplant recipient leading to graft loss and mortality.
Asunto(s)
Enfermedad Hepática en Estado Terminal/cirugía , Fascioliasis/complicaciones , Rechazo de Injerto/parasitología , Trasplante de Hígado , Animales , Niño , Colangitis/tratamiento farmacológico , Medios de Contraste , Enfermedad Hepática en Estado Terminal/diagnóstico por imagen , Fasciola hepatica , Femenino , Humanos , Terapia de Inmunosupresión , Inmunosupresores/uso terapéutico , India , Marruecos , Ácido Micofenólico/uso terapéutico , Trasplante de Células Madre , Tacrolimus/uso terapéutico , Tomografía Computarizada por Rayos XRESUMEN
BACKGROUND: Auxiliary partial orthotopic liver transplantation is a technique where part of diseased native liver is removed and replaced with healthy donor liver so that, the left behind native liver could later regenerate. CASE CHARACTERISTICS: 2 year 6 month old girl with acute liver failure due to Hepatitis A. She underwent a successful auxiliary partial orthotopic liver transplantation. OUTCOME: Successful native liver regeneration and immunosuppression withdrawal after two and half years of surgery. MESSAGE: In selective cases of acute liver failure, auxiliary partial orthotopic liver transplantation could provide a chance for native liver regeneration and immunosuppression-free life.