A Case Report of Successful Semi-Emergent Living Donor Liver Transplantation for Biliary Atresia Patient With Acute Liver Failure and Progressive Portal Hypertension : The Indication of Liver Transplantation for Biliary Atresia in Infant Patients

Abstract

In infant patients with a low body weight who develop liver failure following a Kasai portoenterostomy for biliary atresia (BA), a sufficient increase in body weight is desirable prior to undergoing liver transplantation (LT) because of a high risk of postoperative complications. In the present case, we report the successful semi-emergent living donor liver transplantation for BA in an infant patient with acute liver failure. The patient was an 11-month-old female patient with BA. Her body weight was 5.2kg. The patient suffered from acute liver failure and progressive portal hypertension due to uncontrollable infection during the waiting period for LT. Thereafter, intubation and artificial ventilation was performed because of the onset of respiratory failure due to abdominal distension with hepatomegaly and splenomegaly. Therefore, a semi-emergent living donor liver transplantation was performed because an increase in body weight was not desirable. It is important for infant BA patients with a low body weight to be assessed for multiple biliary cyst, uncontrollable infection, hypercytokinemia and progressive splenomegaly. If their conditions are fulfilled, we should consider that as a clear indication for the need to perform semi-emergent LT because of a high risk of perioperative complications.