Case Report
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 28, 2017; 23(40): 7337-7342
Published online Oct 28, 2017. doi: 10.3748/wjg.v23.i40.7337
Rescue case of low birth weight infant with acute hepatic failure
Noriki Okada, Yukihiro Sanada, Taizen Urahashi, Yoshiyuki Ihara, Naoya Yamada, Yuta Hirata, Takumi Katano, Kentaro Ushijima, Shinya Otomo, Shujiro Fujita, Koichi Mizuta
Noriki Okada, Yukihiro Sanada, Taizen Urahashi, Yoshiyuki Ihara, Naoya Yamada, Yuta Hirata, Takumi Katano, Koichi Mizuta, Department of Transplant Surgery, Jichi Medical University, Shimotsuke 3290498, Japan
Kentaro Ushijima, Department of Clinical Pharmacology, Jichi Medical University, Shimotsuke 3290498, Japan
Shinya Otomo, Department of Pharmacy, Jichi Medical University, Shimotsuke 3290498, Japan
Shujiro Fujita, Department of Pediatrics, Yokohama City University School of Medicine, Yokohama 2360004, Japan
Author contributions: Okada N contributed to the conception of the manuscript; Sanada Y, Urahashi T, Ihara Y, Yamada N, Hirata Y, Katano T, Ushijima K, Otomo S and Fujita S performed the treatment and collected data; Okada N drafted the manuscript; Mizuta K reviewed the manuscript; all authors read and approved the final manuscript.
Institutional review board statement: This study was reviewed and approved by the Ethics Committees of Jichi Medical University (15-106).
Informed consent statement: The patient involved in this study gave informed consent, authorized use and disclosure of protected health information.
Conflict-of-interest statement: The authors have no competing interests to disclose.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Noriki Okada, MD, PhD, Department of Transplant Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke 3290498, Japan. r0906no@jichi.ac.jp
Telephone: +81-285-587069 Fax: +81-285-587069
Received: August 8, 2017
Peer-review started: August 9, 2017
First decision: August 30, 2017
Revised: September 13, 2017
Accepted: September 26, 2017
Article in press: September 26, 2017
Published online: October 28, 2017
Processing time: 81 Days and 18.6 Hours
Abstract

We report a case involving a rescued low birth weight infant (LBWI) with acute liver failure. Case: The patient was 1594 g and 323/7 gestational wk at birth. At the age of 11 d, she developed acute liver failure due to gestational alloimmune liver disease. Exchange transfusion and high-dose gamma globulin therapy were initiated, and body weight increased with enteral nutrition. Exchange transfusion was performed a total of 33 times prior to living donor liver transplantation (LDLT). Her liver dysfunction could not be treated by medications alone. At 55 d old and a body weight of 2946 g, she underwent LDLT using an S2 monosegment graft from her mother. Three years have passed with no reports of intellectual disability or liver dysfunction. LBWIs with acute liver failure may be rescued by LDLT after body weight has increased to over 2500 g.

Keywords: Liver transplantation; Acute liver failure; Low birth weight infant; Transplantable body weight; Monosegment graft

Core tip: We report a case involving a rescued low birth weight infant (LBWI) with acute liver failure. The patient was 1594 g at birth. At the age of 11 d, she developed acute liver failure due to gestational alloimmune liver disease. Medications were initiated, and body weight increased with enteral nutrition. Her liver dysfunction could not be treated by medications alone. At 55 d old with a body weight of 2946 g, she underwent living-donor liver transplantation (LDLT) using an S2 monosegment graft. Conclusion: LBWIs with acute liver failure may be rescued by LDLT after body weight has increased to over 2500 g.