{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T13:55:54Z","timestamp":1779198954347,"version":"3.51.4"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":4170,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2004,4]]},"abstract":"<jats:sec>\n            <jats:title\/>\n            <jats:p>Two-stage total hepatectomy and liver transplantation has been reported for acute liver disease such as fulminant hepatic failure, primary graft failure, severe hepatic trauma, and spontaneous hepatic rupture secondary to hemolysis, elevated liver function tests, low platelets syndrome, and preeclampsia. This is the first report of patients with cirrhosis to undergo a 2-stage total hepatectomy and liver transplantation. From 1984 to 2002, our institution performed 2008 orthotopic liver transplantations. We identified 4 patients with chronic liver disease who underwent a 2-stage hepatectomy and liver transplantation. This is a retrospective review of these 4 patients and a review of the literature on this procedure. All 4 patients were young men with an age range of 29-31 years and had underlying cirrhosis as well as a previous transjugular intrahepatic portosystemic shunt (TIPS)procedure. Acute decompensation fulfilling Ringes\u2019 criteria for toxic liver syndrome secondary to an upper gastrointestinal bleed occurred in all patients. The approximate average time between hepatectomy and liver transplantation was 20 hours (range: 8-42 hours). In all cases, the explanted liver showed histological changes of acute hepatic necrosis within the background of cirrhosis. After hepatectomy, vasopressor requirements were well documented in 2 patients. For 1 patient, there was a clear improvement in their hemodynamic status. The mean hospital stay of the 4 patients was 63 days. All patients were discharged from the hospital and are alive and well with adequate liver function at 6 to 37 months follow-up. Two-stage total hepatectomy and liver transplantation may be a life-saving procedure in highly selected cirrhotic patients with acute hepatic decompensation and multiorgan dysfunction. (Liver Transpl 2004;10:564-570.)<\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/lt.20134","type":"journal-article","created":{"date-parts":[[2004,3,23]],"date-time":"2004-03-23T13:38:07Z","timestamp":1080049087000},"page":"564-570","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":25,"title":["Two-stage total hepatectomy and liver transplantation for acute deterioration of chronic liver disease: A new bridge to transplantation"],"prefix":"10.1097","volume":"10","author":[{"given":"Michael J.","family":"Guirl","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey S.","family":"Weinstein","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert M.","family":"Goldstein","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marlon F.","family":"Levy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Goran B.","family":"Klintmalm","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R2-16-20250326","doi-asserted-by":"crossref","first-page":"898899","DOI":"10.1016\/0140-6736(93)91947-K","article-title":"Control of cerebral oedema by total hepatectomy and extracorpeal liver support in fulminant hepatic failure.","volume":"342","author":"Rozga","year":"1993","journal-title":"Lancet"},{"key":"R3-16-20250326","doi-asserted-by":"crossref","first-page":"318319","DOI":"10.5694\/j.1326-5377.1994.tb127454.x","article-title":"Total hepatectomy and liver transplantation as a two-stage procedure in fulminant hepatic failure.","volume":"161","author":"Henderson","year":"1994","journal-title":"Med J Aust"},{"key":"R5-16-20250326","first-page":"19621963","article-title":"Successful retransplantation after a 48-hour anhepatic state.","volume":"25","author":"So","year":"1993","journal-title":"Transplant Proc"},{"key":"R6-16-20250326","doi-asserted-by":"crossref","first-page":"10241028","DOI":"10.1097\/00007890-199904150-00015","article-title":"Rescue hepatectomy for initial graft non-function after liver transplantation.","volume":"67","author":"Oldhafer","year":"1999","journal-title":"Transplantation"},{"key":"R7-16-20250326","first-page":"792795","article-title":"Management of severe hepatic trauma by two-stage total hepatectomy and subsequent liver transplantation.","volume":"109","author":"Ringe","year":"1991","journal-title":"Surgery"},{"key":"R8-16-20250326","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1097\/00000658-199307000-00002","article-title":"Total hepatectomy and liver transplantation as two-stage procedure.","volume":"218","author":"Ringe","year":"1993","journal-title":"Ann Surg"},{"key":"R9-16-20250326","doi-asserted-by":"crossref","first-page":"837839","DOI":"10.1002\/bjs.1800820637","article-title":"Total hepatectomy and liver transplantation: a life-saving procedure in patients with severe hepatic trauma.","volume":"82","author":"Ringe","year":"1995","journal-title":"Br J Surg"},{"key":"R10-16-20250326","first-page":"184190","article-title":"Relevance of two-stage total hepatectomy and liver transplantation in acute liver failure and severe liver trauma.","volume":"14","author":"Fernandez","year":"2001","journal-title":"Transpl Int"},{"key":"R11-16-20250326","doi-asserted-by":"crossref","first-page":"179181","DOI":"10.1111\/j.1432-2277.1993.tb00643.x","article-title":"Acute liver necrosis in the HELLP syndrome: successful outcome after orthotopic liver transplantation. 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