HELLP syndrome as an indication for liver transplantation

Liver rupture followed by multiorgan failure is perhaps the most catastroph ic complication of the HELLP syndrome (hemolysis, elevated liver function, low platelets). Specific treatment options are currently limited and not ro utinely clarified. Here, we present a patient successfully managed by an in novative surgical approach consisting of combined total hepatectomy, portac aval shunt, and liver transplantation. A 26-year-old primipara (39th week o f gestation) who suffered liver rupture as a complication of HELLP syndrome after delivery underwent a portacaval shunt after total hepatectomy. This combination was sufficient until the patient underwent orthotopic liver tra nsplantation. The patient was discharged from the hospital after a dramatic recovery. Bridging portacaval shunt and consecutive orthotopic liver trans plantation represented an effective therapy for this patient and should be considered early as a treatment option in patients with liver rupture compl icating severe HELLP syndrome. Copyright (C) 2001 S. KargerAG, Basel.