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Frontiers of Medicine

ISSN 2095-0217

ISSN 2095-0225(Online)

CN 11-5983/R

Postal Subscription Code 80-967

2018 Impact Factor: 1.847

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Front. Med.    2014, Vol. 8 Issue (2) : 250-253    https://doi.org/10.1007/s11684-014-0333-3
CASE REPORT
Comprehensive treatment of acute-on-chronic liver failure in a patient with hepatitis B: a case report
Lei Li1,Yimei Liu1,Tiancheng Luo1,Jian Zhou2,4,Yingyong Hou3,Xizhong Shen1,4,Jiyao Wang1,4,*()
1. Department of Gastroenterology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
2. Department of Liver Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
3. Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
4. Shanghai Institute of Liver Diseases, Shanghai 200032, China
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Abstract

The clinical data of a patient with acute-on-chronic liver failure were analyzed retrospectively. The patient has suffered from hepatitis B for 30 years. His liver function deteriorated, yielding Child-Pugh grade C and reaching a model for end-stage liver disease score of 33 points within a short period; this condition was complicated with highly active variceal bleeding and coagulation system failure (PT > 100 s). The patient also presented hepatocellular carcinoma. Comprehensive treatments included effective inhibition of hepatitis B virus replication and intensive care support. Piggyback orthotopic liver transplantation was performed as the final treatment. The patient recovered uneventfully and was discharged after surgery.
Keywords acute-on-chronic liver failure      submassive necrosis      viral hepatitis B      esophageal variceal bleeding      liver transplantation     
Corresponding Author(s): Jiyao Wang   
Issue Date: 21 May 2014
 Cite this article:   
Jiyao Wang,Lei Li,Yimei Liu, et al. Comprehensive treatment of acute-on-chronic liver failure in a patient with hepatitis B: a case report[J]. Front. Med., 2014, 8(2): 250-253.
 URL:  
https://academic.hep.com.cn/fmd/EN/10.1007/s11684-014-0333-3
https://academic.hep.com.cn/fmd/EN/Y2014/V8/I2/250
Fig.1  Macroscopic view of the specimen (total hepatectomy).
Fig.2  Examination of the resected specimen revealed pathological findings consistent with hepatocellular carcinoma combined with severe fibrosis (5 × 10).
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