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Acute liver failure at 26 weeks' gestation in a patient with sickle cell disease
Author(s) -
Greenberg Mara,
Daugherty Tami J.,
Elihu Arvand,
Sharaf Ravi,
Concepcion Waldo,
Druzin Maurice,
Esquivel Carlos O.
Publication year - 2009
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.21820
Subject(s) - medicine , pregnancy , liver transplantation , gestation , fetus , disease , liver disease , obstetrics , transplantation , pediatrics , intensive care medicine , surgery , genetics , biology
Orthotopic liver transplantation (OLT) for acute liver failure (ALF) during pregnancy is an uncommon occurrence with variable outcomes. In pregnancy‐related liver failure, prompt diagnosis and immediate delivery are essential for a reversal of the underlying process and for maternal and fetal survival. In rare cases, the reason for ALF during pregnancy is either unknown or irreversible, and thus OLT may be necessary. This case demonstrates the development of cryptogenic ALF during the 26th week of pregnancy in a woman with sickle cell disease. She underwent successful cesarean delivery of a healthy male fetus at 27 weeks with concurrent OLT. This report provides a literature review of OLT in pregnancy and examines the common causes of ALF in the pregnant patient. On the basis of the management and outcome of our case and the literature review, we present an algorithm for the suggested management of ALF in pregnancy. Liver Transpl 15:1236–1241, 2009. © 2009 AASLD.