Living donor liver transplantation for acute liver failure with fixed pupils: Are we fixed?

Abstract Living donor liver transplantation (LDLT) is fraught with the social and ethical dilemma of excising a part of the liver from a healthy first degree relative. When LDLT is to be done for an acute liver failure (ALF), identification of a suitable donor is a race against time. Here we describ...

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Bibliographic Details
Published in:Journal of clinical and experimental hepatology 2017-06, Vol.7 (2), p.155-157
Main Authors: Singh, Shweta A., Dr, Singh, Anshuman, Pamecha, Viniyendra, Dr, Pandey, C.K, Sarin, S.K., Dr
Format: Article
Language:English
Subjects:
acute liver failure
Case Report
Endocrinology & Metabolism
fixed dilated pupils
Gastroenterology and Hepatology
living donor liver transplantation
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Summary:Abstract Living donor liver transplantation (LDLT) is fraught with the social and ethical dilemma of excising a part of the liver from a healthy first degree relative. When LDLT is to be done for an acute liver failure (ALF), identification of a suitable donor is a race against time. Here we describe a unique challenge faced by the transplant team of whether to proceed with donor hepatectomy from a son, when the recipient (HBV related ALF) developed nonreactive fully dilated pupils on table, prior to beginning the surgery. The patient ultimately underwent a LDLT despite fixed dilated pupils by virtue of further workup which suggested that cerebral blood flow was maintained despite clinical evidence of brainstem herniation.
ISSN:0973-6883
2213-3453
DOI:10.1016/j.jceh.2016.09.014