Auxiliary Liver Transplantation for Acute Liver Failure
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Case :
A 2½-year-old child from the Arabic Gulf with Hepatitis A induced ALF developed hepatic encephalopathy and was intubated and ventilated. As the child fulfilled liver transplantation criteria, she was stabilized and airlifted to our center for Living Related LT. At the time of surgery, she had already been ventilated for 12 days and was critically ill with INR of 6, lactate of 5.5 mmol/Land bilirubin of 17.8 mg/dL. The native left liver lobe of the child was resected and replaced with left lateral segment from the donor, who was her paternal uncle. She was started on standard immunosuppression with tacrolimus and steroids. Her lactate and INR normalized in two days and bilirubin normalized in seven days. Postoperative period was complicated by hypotension requiring inotropic support, sepsis, narcotic withdrawal, and prolonged ventilation necessitating tracheostomy. She was off-ventilator two weeks after APOLT, and was discharged home four weeks after surgery.........

http://www.indianpediatrics.net/jan2016/jan-67-69.htm
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