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Case Reports in Transplantation
Volume 2012 (2012), Article ID 484080, 7 pages
http://dx.doi.org/10.1155/2012/484080
Case Report

Liver Transplantation for Acute Liver Failure at 11-Week Gestation with Successful Maternal and Fetal Outcome

1Division of Hepatology, Carolinas Medical Center, 1000 Blythe Boulevard, Charlotte, NC 28203, USA
2Department of Obstetrics and Gynecology, Carolinas Medical Center, 1000 Blythe Boulevard, Charlotte, NC 28203, USA
3Department of Surgery, Carolinas Medical Center, 1000 Blythe Boulevard, Charlotte, NC 28203, USA
4Department of Pathology, Carolinas Medical Center, 1000 Blythe Boulevard, Charlotte, NC 28203, USA
5Carolinas Digestive Health Associates, Charlotte, NC 28211, USA
6Transplant Center, Carolinas Medical Center, 3rd Floor Annex building, Charlotte, NC 28203, USA

Received 17 September 2012; Accepted 24 October 2012

Academic Editors: J. Kaneko and G. Schlaf

Copyright © 2012 Vinaya C. Maddukuri et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Acute liver failure (ALF) during pregnancy is very uncommon. Pregnancy-specific liver conditions like hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome and acute fatty liver of pregnancy can cause ALF at term or postpartum, but, typically occur during the third trimester. Most of these patients recover spontaneously after delivery, but, on occasion, they require liver transplantation in the postpartum period. However, ALF during the first and second trimester of pregnancy requiring antepartum liver transplantation is rare. Only fifteen cases of liver transplantation during pregnancy have been reported, and very few occurred during the first trimester. We report a Woman who developed acute liver failure during the first trimester of pregnancy and underwent successful liver transplantation at 11-week gestation, followed by successful delivery of the fetus at 30 weeks. To our knowledge, this is the earliest case of successful liver transplantation during pregnancy followed by successful fetal outcome. We discuss management of the patient and fetus before, during, and after liver transplantation and review the literature on antepartum liver transplant in pregnancy.