A case of primary non-function following adult-to-adult living donor liver transplantation

We report a case of primary non-function of graft liver following adult-to-adult living donor liver transplantation. The recipient was a 43-year-old male with hepatitis B-associated liver cirrhosis. The donor was a 28-year-old brother of the recipient. We transplanted a left lobe graft from the donor weighing 550g, in which 20% macrovesicular steatosis was observed. Total ischemic time was less than 40 minutes. The recipient presented a marked impairment of coagulation profile and marked elevation of liver enzymes without any evidence of flow disturbance of the liver vessels, which was very similar to the clinical course of primary non-function following cadaveric donor liver transplantation. We performed retransplantation using a cadaveric whole liver graft on the second day after the initial operation and the recipient survived without any complications. A resected graft liver specimen showed total necrosis of hepatocytes without intravascular thrombosis. We concluded that failure of the living donor graft was due to primary non-function occurring in the adult recipient.