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Isoniazid-related fulminant hepatic failure in a child: assessment of the native liver’s early regeneration after auxiliary partial orthotopic liver transplantation

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Transplant International

Abstract

We report the first case of auxiliary partial orthotopic liver transplantation (APOLT) in a patient with isoniazid (INH)-related fulminant hepatic failure (FHF) with the aim to determine the ability of the native liver (NL) to recover after this particular toxic event. A 10-year-old boy with INH-related FHF underwent APOLT after left hepatectomy on the NL. Neurological status and liver function rapidly improved, but, on postoperative day 22, urgent re-transplantation was needed for graft–hepatic artery thrombosis (HAT) and the NL’s incapacity to sustain adequate liver function. Histological examination of the NL showed signs evident of its regeneration, however. In conclusion, though we faced the clinical failure of the NL functionally to sustain the patient in the presence of the graft HAT 3, weeks after APOLT, such a failure may be interpreted as time related. In fact, the histological picture in this particular case may suggest the potential for NL recovery after INH-related FHF.

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Authors and Affiliations

  1. Clinica Chirurgica no. 1, Department of Surgical and Gastroenterological Sciences, University of Padua School of Medicine, Via Giustiniani 2, Policlinico III piano, 35128, Padua, Italy

    Umberto Cillo, Marco Bassanello, Alessandro Vitale, Giacomo Zanus, Alberto Brolese, Francesco Antonio Ciarleglio & Davide Francesco D’Amico

  2. Dipartimento di Pediatria, University of Padua, Padua, Italy

    Lorenzo D’Antiga, Graziella Guariso & Lucia Zancan

  3. Divisione di Gastroenterologia, Dipartimento di Scienze Chirurgiche e Gastroenterlogiche, University of Padua, Padua, Italy

    Patrizia Burra

  4. II Unità Operativa di Anatomia Patologica, University of Padua, Padua, Italy

    Maria Guido

Authors
  1. Umberto Cillo
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  2. Marco Bassanello
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  3. Alessandro Vitale
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  4. Lorenzo D’Antiga
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  5. Giacomo Zanus
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  6. Alberto Brolese
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  7. Patrizia Burra
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  8. Francesco Antonio Ciarleglio
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  9. Graziella Guariso
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  10. Lucia Zancan
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  11. Maria Guido
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  12. Davide Francesco D’Amico
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Corresponding author

Correspondence to Alessandro Vitale.

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Cillo, U., Bassanello, M., Vitale, A. et al. Isoniazid-related fulminant hepatic failure in a child: assessment of the native liver’s early regeneration after auxiliary partial orthotopic liver transplantation. Transpl Int 17, 713–716 (2005). https://doi.org/10.1007/s00147-004-0798-0

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  • DOI: https://doi.org/10.1007/s00147-004-0798-0

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