Emergency ABO-incompatible living donor liver transplant for patients with ultrahigh MELD scores

摘要

To the Editor:A 49-year-old Chinese man with treatment-naive chronic hepatitis B presented with a one-week history of jaundice when admitted to our hospital.On admission,his bilirubin was 704μmol/L,alanine aminotransferase 180 U/L,international normalized ratio 2.4,creatinine 140μmol/L,and Model for End-stage Liver Disease(MELD)score 35.His serum HBV DNA was 64.7 IU/mL,and he was commenced on entecavir.Nonetheless,he developed acute-onchronic liver failure on day 28 with grade 2 hepatic encephalopathy and a MELD score of 40(bilirubin 709μmol/L,international normalized ratio 3.3,creatinine 181μmol/L).