Two-staged living donor liver transplantation for fulminant hepatic failure.

We reported a first successful and life-saving two-staged living-related liver transplantation for a patient with imminent brain death due to fulminant hepatic failure that otherwise had to be performed after a pre-treated and scheduled blood-type incompatible liver transplantation. The patient was anhepatic for 6 hr 34 min, and continuous hemodiafiltration was given throughout the operation. The patient recovered quickly and was extubated within 24 hr after transplant. This two-staged procedure is useful for emergency living-related liver transplantation that needs to be performed when the operating room is busy with other emergency or scheduled surgical procedures, and may allow clearance of toxic metabolites during the anhepatic period.