Fulminant hepatitis A infection in second trimester of pregnancy requiring living-donor liver transplantation

Simsek Y., IŞIK B., KARAER A., Celik O., KUTLU R., Aydin N. E., ...More

JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH, vol.38, no.4, pp.745-748, 2012 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 38 Issue: 4
  • Publication Date: 2012
  • Doi Number: 10.1111/j.1447-0756.2011.01757.x
  • Journal Name: JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.745-748
  • Keywords: hepatic encephalopathy, hepatic failure, hepatitis A, liver transplantation, pregnancy, A INFECTION, FAILURE, PROGNOSIS
  • Inonu University Affiliated: Yes

Abstract

We present an 18-year-old pregnant woman who was referred to our emergency clinic as a case of acute hepatic failure and hepatic encephalopathy. Laboratory tests showed abnormal liver function tests and serological workup was consistent with acute hepatitis A infection. Ultrasonography revealed a single live fetus with fetal biometry compatible with 18 gestational weeks. The patient underwent a highly urgent liver transplantation using a right lobe graft from her husband. Histological examination of the explanted liver showed acute, lymphocyte-rich, diffuse necrotizing hepatitis, consistent with acute necrotizing hepatitis A. After the operation her allograft function gradually recovered. Her follow-up obstetrics ultrasound revealed a male fetus with severely decreased amniotic fluid. The patient was informed about the poor prognosis of her pregnancy and the pregnancy was terminated by vaginal misoprostol induction. She has maintained a good general condition and liver function for 4 months postoperatively, up to the present time.