Two-stage liver transplant for ruptured hepatic adenoma: A case report

Marc Salhanick, Malcolm P. MacConmara, Mark R. Pedersen, Lafaine Grant, Christine S. Hwang, Justin R. Parekh

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


BACKGROUND Only one case of liver transplantation for hepatic adenoma has previously been reported for patients with rupture and uncontrolled hemorrhage. We present the case of a massive ruptured hepatic adenoma with persistent hemorrhagic shock and toxic liver syndrome which resulted in a two-stage liver transplantation. This is the first case of a two-stage liver transplantation performed for a ruptured hepatic adenoma. CASE SUMMARY A 23 years old African American female with a history of pre-diabetes and oral contraceptive presented to an outside facility complaining of right-sided chest pain and emesis for one day. She was found to be in hemorrhagic shock due to a massive ruptured hepatic hepatic adenoma. She underwent repeated embolizations with interventional radiology with ongoing hemorrhage and the development of renal failure, hepatic failure, and hemodynamic instability, known as toxic liver syndrome. In the setting of uncontrolled hemorrhage and toxic liver syndrome, a hepatectomy with porto-caval anastomosis was performed with liver transplantation 15 h later. She tolerated the anhepatic stage well, and has done well over one year later. CONCLUSION When toxic liver syndrome is recognized, liver transplantation with or without hepatectomy should be considered before the patient becomes unstable.

Original languageEnglish (US)
Pages (from-to)242-249
Number of pages8
JournalWorld Journal of Hepatology
Issue number2
StatePublished - 2019


  • Case report
  • Hepatectomy
  • Hepatic adenoma
  • Ruptured adenoma
  • Toxic liver syndrome
  • Two-stage liver transplantation

ASJC Scopus subject areas

  • Hepatology


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