Long-term survival after postpartum liver rupture and necrosis requiring liver transplantation in a twin pregnancy.

A 32-year-old G6P5 (hepatitis B carrier, of African origin) with a spontaneous twin pregnancy gave birth at the 37th gestational week. Four hours later she collapsed. Upon an emergency laparotomy, right liver lobe rupture and later massive liver necrosis were diagnosed. Four days later, a liver transplantation was performed. She was discharged from the hospital 38 days after her delivery, four laparotomies, and having received 179 units of red blood cells, 221 units of fresh frozen plasma, 144 units of platelets, and various separate clotting concentrates. As a result of immune suppression medication, she later developed diabetes, sarcoma Kaposi, a Pneumocystis carinii pneumonia, and coenurosis. Four years later, she is, however, in a relatively good condition.