03-25-2007, 10:58 AM
A 28 year old woman is hospitalized after taking a massive overdose of acetaminophen tablets in a suicide attempt. She has type 1 diabetes mellitus and major depressive disorder refractory to tricyclic antidepressant therapy. Despite appropriate therapy, she develps rapidly progressive hepatic failure and becomes progressively encephalopathic. On the 6th day of hospitalization, she is comatose. A CT scan of the brain shows mild diffuse swelling. An appropriately crossmatched, size-appropriate donor liver is available. Which of the following is the most appropriate course of action regarding transplantation?
A. Do not proceed with the transplantation because DM is a contraindication
B. Do not proceed with the transplantation because hepatic function is likely to return over the next week.
C. Do not proceed with the transplantation because major depressive disorder places the patient at risk for another suicide attempt.
E. Proceed with the transplantation