Introduction: Iatrogenic injuries to vital structures of the liver and liver failure post liver resection are both associated with high mortality. Selected patients that were previously considered unsuitable for liver transplantation may be offered a transplant as a life saving procedure. There are currently few published reports exploring the indications and outcomes in this patient group. This report presents our results with rescue liver transplantation.

Material and methods: From 1984 to Dec 1st 2017 a total of 1498 liver transplantations were performed in our institution. Thirteen were performed as a life saving procedure in patients suffering from either post liver resection failure or iatrogenic injury related to surgery. This data was investigated retrospectively.

Results:

Lt; liver transplantation, NET; neuroendocrine tumor, PV; portal vein, HA; hepatic artery, HCC; hepatocellular carcinoma, HAS; hepatic artery stenosis, CRLM; colorectal liver metastasis, HAT; hepatic artery thrombosis

Conclusion: Liver transplantation is a lifesaving procedure for patients who suffer from devastating iatrogenic injuries during surgery and for patients experiencing remnant liver failure after resection. Seven of the thirteen patients underwent radical surgery due to cancer prior to transplantation. Three of these seven patients did not experience recurrence, while four did and died 78, 45, 24 and 7 months after transplantation, the primary disease being colorectal liver metastasis (3) or duodenal carcinoma (1). The remaining six patients fully recovered. The current donor situation in Norway allows us to offer liver transplantation to this heterogeneous patient group with fatal liver injuries or failure. However, it is still controversial whether it is justified to utilize donor livers to patients with liver failure after resection for CRLM.

CITATION INFORMATION: Thorsen T., Solheim J., Horneland R., Line P-.D., Labori K., Aandahl E. Liver Transplantation as a Life Saving Procedure after Post Resection Liver Failure and Iatrogenic Liver Injuries Am J Transplant. 2017;17 (suppl 3).

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