Good outcome of living donor liver transplantation in drug‐induced acute liver failure: A single‐center experience. Issue 3 (March 2017)

• Record Type: Journal Article
• Authors: Choudhary, Narendra Singh; Saigal, Sanjiv; Saraf, Neeraj; Rastogi, Amit; Goja, Sanjay; Bhangui, Prashant; Vohra, Vijay; Govil, Deepak; Soin, Arvinder S.
• Is Part Of: Clinical transplantation. Volume 31:Issue 3(2017)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2017-03
• Subjects: acute liver failure -- antitubercular treatment -- drug‐induced liver injury -- living donor liver transplantation -- survival; Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ctr.12907
• Languages: English
• ISSNs: 0902-0063

Abstract

Abstract: Introduction: Drug‐induced acute liver failure (ALF) is associated with high mortality. There is limited literature on results of living donor liver transplantation (LDLT). Material and Methods: The study was conducted at a tertiary care center in North India. All patients who received LDLT for drug‐induced ALF were included. The data are shown as median (IQR). Results: A total of 18 patients (15 females and three males), aged 34 (25‐45) years, underwent LDLT for drug‐induced liver injury (DILI)‐related ALF. Etiology of ALF was antitubercular medications (n=14), orlistat (n=1), flutamide (n=1), and complementary alternative medications (n=2). The baseline parameters were as following: bilirubin 17.7 (16.3‐23.8) mg/dL, INR 3.3 (2.5‐4.0), jaundice encephalopathy interval 6 (3‐17.5) days, arterial ammonia 109 μmol/L (73‐215), Model for End‐Stage Liver Disease (MELD) 24 (18‐33), grade of encephalopathy 2 (1‐4), which progressed to grade 3 (3‐4) before transplantation. All patients underwent right lobe LDLT; hospital stay was 17 (13‐22) days, and ICU stay was 5 (5‐7) days. Two patients died in the first month after liver transplantation due to sepsis and multi‐organ failure; the rest of the patients are alive and doing well at a follow‐up of 50 (4‐82 months). Conclusion: Good outcomes can be obtained by LDLT for drug‐induced ALF.