Endoscopic management of biliary obstruction after successful reuse of a liver graft

Background: The widening gap between donated organs and potential recipients waiting for liver transplantation leads towards intensive efforts to increase the availability of liver grafts. Case Reports: Here we present two case reports in which we reused a liver graft 24 hours after the first transplantation and present the successful endoscopic management of biliary obstruction. The first recipient died 17 hours after successful transplantation causes by massive cerebral oedema. After informed consent of the relatives the liver was explanted and successfully reused for a second recipient. After 6 days a biliary obstruction caused by gall stones was diagnosed and successfully controlled by endoscopic stone extraction. Conclusions: This report reaffirms the possibility of reusing a liver graft with excellent organ function in a second recipient, and that major biliary complications can be successfully handled by early diagnosis and interdisciplinary management.