Emergency ABO-incompatible living donor liver transplant for patients with ultrahigh MELD scores
Kevin KW Chu a , Kenneth SH Chok a , ∗, James YY Fung b , Albert CY Chan a , Wing Chiu Dai a , Chung Mau Lo a
a Department of Surgery, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China
b Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China
Abstract：A 49-year-old Chinese man with treatment-naïve chronic hepatitis B presented with a one-week history of jaundice when admitted to our hospital. On admission, his bilirubin was 704 μmol/L, alanine aminotransferase 180 U/L, international normalized ratio 2.4, creatinine 140 μmol/L, and Model for End-stage Liver Disease (MELD) score 35. His serum HBV DNA was 64.7 IU/mL, and he was commenced on entecavir. Nonetheless, he developed acute-onchronic liver failure on day 28 with grade 2 hepatic encephalopathy and a MELD score of 40 (bilirubin 709 μmol/L, international normalized ratio 3.3, creatinine 181 μmol/L). During his admission, he developed bacteremia and spontaneous bacterial peritonitis (SBP). His blood culture was positive of enterococcus faecium and coagulase-negative staphylococcus and his peritoneal fluid culture was positive of coagulase-negative staphylococcus . This was further complicated by the development of type 1 hepatorenal syndrome. His initial condition was so poor that intensive care with inotrope was needed. At the time of preconditioning, the sepsis due to SBP was barely controlled after optimization.
引用本文:
. [J]. Hepatobiliary Pancreat Dis Int, 2019, 18(1): 87-89.
Chu KKW, Chok KSH, Fung JYY, Chan ACY, DaiWC, Lo CM. Emergency ABO-incompatible living donor liver transplant for patients with ultrahigh MELD scores. Hepatobiliary Pancreat Dis Int, 2019, 18(1): 87-89.
2019, Vol. 18 
