Hip Arthroplasty in an Acute-On-Chronic Liver Failure Patient Followed by Early Live Donor Liver Transplant

Abstract An acute-on-chronic liver disease patient, during workup for liver transplant, presented with a transcervical neck of femur fracture following a trivial trauma. High risks were associated with performing the surgery under general anesthesia, coagulation failure, and risks of infection, resulting in intraoperative or post-operative mortality. Addressing each of these risk factors, the patient underwent a cemented bipolar hemiarthroplasty under regional nerve block, followed by early live donor liver transplantation with an uneventful post-op recovery and currently mobilizing without support. In the case of patients with acute-on-chronic liver failure, identifying the risk factors and complications that are expected perioperatively and intraoperatively and further planning the management by a multidisciplinary team approach can result in improved outcomes.