Liver transplantation for severe hepatic trauma: Experience from a single center

Abstract

Liver transplantation has been reported in the literature as an extreme intervention in cases of severe and complicated hepatic trauma. The main indications for liver transplant in such cases were uncontrollable bleeding and postoperative hepatic insufficiency. We here describe four cases of orthotopic liver transplantation after penetrating or blunt liver trauma. The indications were liver failure, extended liver necrosis, liver gangrene and multiple episodes of gastrointestinal bleeding related to portal hypertension, respectively. One patient died due to postoperative cerebral edema. The other three patients recovered well and remain on immunosuppression. Liver transplantation should be considered as a saving procedure in severe hepatic trauma, when all other treatment modalities fail.

Liver transplantation after severe hepatic trauma: a sustainable practice. A single‐center experience and review of the literature

“…After excluding a case of auto‐transplantation , six double reports and a case for which no information about the management was provided , 30 patients were identified and pooled with the four patients in our series, for a total of 34 patients. Table shows a synopsis of the present series.…”

Prometheus bound

“…Indications for hepatic transplantation in the setting of extremely complicated injuries are as follows: (i) uncontrollable hemorrhage despite all methods of intervention; (ii) postoperative hepatic failure either acute or progressive; and (iii) injuries to the main portal triad structure that cannot be reconstructed. [35][36][37] Clearly, the most limiting factor in the employment of this technique is the lack of available organs for transplantation. Usually, a two-stage approach is adopted.…”

Chirurgische Therapie des Lebertraumas

“…Überwiegend handelt es sich nach stumpfem Bauchtrauma um I-bis derates Lebertrauma anzusehen sind und zumeist konservativ therapiert werden können [75]. [4,15,24,28,38,42,60,61,62].…”