Clinical Journal of Gastroenterology

, Volume 12, Issue 2, pp 112–119 | Cite as

An intensive medical care network led to successful living-donor liver transplantation in late-onset hepatic failure with disseminated Staphylococcus aureus infection

  • Rie Kure
  • Natsumi Uehara
  • Kazuaki InoueEmail author
  • Tomomi KogisoEmail author
  • Kazuhisa Kodama
  • Makiko Taniai
  • Katsutoshi Tokushige
  • Masayuki Nakano
  • Hiroto Egawa
  • Masakazu Yamamoto
Case Report


Here, we describe a 42-year-old male patient with late-onset hepatic failure (LOHF) due to acute-onset autoimmune hepatitis. At first, his response to steroid therapy was good, but hepatitis relapsed during steroid pulse therapy. Deterioration of liver function caused LOHF, and LOHF has a poor prognosis, particularly when it is complicated by infection. Systemic infection by Staphylococcus aureus resulted in a skin rash and septic pulmonary embolism, and is an absolute contraindication for liver transplantation (LT). In this treatment network, hepatologists and a transplant surgeon cooperated to overcome severe infection and their efforts led to successful transplantation. On-line hemodiafiltration is an indispensable treatment option for acute liver failure. Infection control is crucial for LT and an intensive medical care network led to successful living-donor LT.


Liver transplantation Staphylococcus aureus Skin rash Septic pulmonary embolism 


Compliance with ethical standards

Conflict of interest

Professor Katsutoshi Tokushige received research fundings from Sumitomo Dainippon Pharma Co., Ltd. Astellas Phama Inc. Eisai Co., Ltd. TAIHO Pharmaceutical Co., Ltd. Chugai Pharmaceutical Co., Ltd. Daiichi Sankyo Pharmaceutical Co., Ltd. AbbVie GK, Takeda Pharmaceutical Company Limited. Asahi Kasei Corporation. AJINOMOTO CO., Inc. Otsuka Pharmaceutical Co., Ltd. Other authors have no conflict of interest.

Human/animal rights

All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Informed consent

Informed consent was obtained from all patients for being included in the study.


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Copyright information

© Japanese Society of Gastroenterology 2018

Authors and Affiliations

  1. 1.Department of Internal Medicine, Institute of GastroenterologyTokyo Women’s Medical UniversityTokyoJapan
  2. 2.Division of Gastroenterology, Department of Internal MedicineShowa University Fujigaoka HospitalYokohamaJapan
  3. 3.Division of Diagnostic PathologyShonan Fujisawa Tokushuukai HospitalFujisawa-shiJapan
  4. 4.Department of Surgery, Institute of GastroenterologyTokyo Women’s Medical UniversityTokyoJapan

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