Abstract:
We present an 18-year-old pregnant woman who was referred to our emergency clinic as a case of acute hepatic
failure and hepatic encephalopathy. Laboratory tests showed abnormal liver function tests and serological
workup was consistent with acute hepatitis A infection. Ultrasonography revealed a single live fetus with fetal
biometry compatible with 18 gestational weeks. The patient underwent a highly urgent liver transplantation
using a right lobe graft from her husband. Histological examination of the explanted liver showed acute,
lymphocyte-rich, diffuse necrotizing hepatitis, consistent with acute necrotizing hepatitis A. After the operation
her allograft function gradually recovered. Her follow-up obstetrics ultrasound revealed a male fetus with
severely decreased amniotic fluid. The patient was informed about the poor prognosis of her pregnancy and
the pregnancy was terminated by vaginal misoprostol induction. She has maintained a good general condition
and liver function for 4 months postoperatively, up to the present time.
