One Step at a Time: A Pediatric Case of Primary Two Staged Liver Transplantation in a Child with ESLD

Toxic liver syndrome is a rare condition with multiorgan failure in end-stage disease (ESLD), and two-stage LT following hepatectomy prolonged anhepatic phase an accepted approach to bridge transplant. This primary has not been described for toxic children ESLD. We report 6-year-old boy who developed while awaiting ESLD from biliary atresia failed Kasai at the age of 2 years. Deemed too sick transplant, he underwent full portocaval shunt placement. The child was then transplanted hemodynamically stable after 10 h 30 min. Although his initial graft showed dysfunction needed re-transplantation 14 days, able leave hospital 4 months 2nd well fully working 5 years later. Primary two stage feasible dire situations.