Objective: To investigate the clinic features and treatment of seventh day syndrome (7DS) following living donor liver transplantation (LDLT).
Methods: From January 2002 to March 2009, 8 patients were diagnosed with 7DS following LDLT. A retrospective analysis was made on the clinical data containing liver and renal functions, coagulation function, sonographic and histological features and effectiveness of the treatments.
Results: Rapid deterioration of liver function happened 1-2 weeks after operations, followed by renal dysfunction. There was a reduction of velocity or bidirectional blood flow in the portal vein. Massive coagulative necrosis with disruption of lobular architecture occurred in 3.3% of cases, with a mortality of 87.5%. The steroid pulse and OKT3 (anti-CD3 antibody) therapy showed minimal effects. Prolonged application of i.v. methylprednisolone may be helpful with the delay of 7DS.
Conclusion: The 7DS may be an immune-mediated graft failure. The prevention and control of 7DS is difficult due to lack of research evidence.