Liver Transplantation for Diffuse Infantile Hepatic Hemangioma and Acute Liver Failure: A Case Report

Authors

• Elana P. Kleinman, Department of Pediatrics, MedStar Georgetown University Hospital, Washington, DC, USA.
• Nada A. Yazigi, Department of Pediatrics, MedStar Georgetown University Hospital, Washington, DC, USA.
• Carolina Rumbo, Department of Pediatrics, MedStar Georgetown University Hospital, Washington, DC, USA.
• Roaa A. Aljuaid, Department of Pathology, MedStar Georgetown University Hospital, Washington, DC, USA.
• Udeme D. Ekong, Department of Pediatrics, MedStar Georgetown University Hospital, Washington, DC, USA.
• Khalid M. Khan, Department of Pediatrics, MedStar Georgetown University Hospital, Washington, DC, USA.
• Bhaskar V. Kallakury, Department of Pathology, MedStar Georgetown University Hospital, Washington, DC, USA.
• Anna Yasmine Kirkorian, Department of Dermatology, Children's National Hospital, Washington, DC, USA.
• Colleen H. Cotton, Department of Dermatology, Children's National Hospital, Washington, DC, USA.
• Radhika Srivastava, Department of Dermatology, Children's National Hospital, Washington, DC, USA.
• Kelly M. Weaver, MedStar Georgetown Transplant Institute, Washington, DC, USA.
• Julia Clayton, MedStar Georgetown Transplant Institute, Washington, DC, USA.
• Michelle Eaton, MedStar Georgetown Transplant Institute, Washington, DC, USA.
• Piyush Gupta, MedStar Georgetown Transplant Institute, Washington, DC, USA.
• Brian M. Nguyen, MedStar Georgetown Transplant Institute, Washington, DC, USA.
• Gabriel J. Hauser, Department of Pediatrics, MedStar Georgetown University Hospital, Washington, DC, USA.
• Cal S. Matsumoto, MedStar Georgetown Transplant Institute, Washington, DC, USA.
• Gabriel E. Gondolesi, MedStar Georgetown Transplant Institute, Washington, DC, USA.

Document Type

Journal Article

Publication Date

3-1-2026

Journal

Pediatric transplantation

Volume

30

Issue

3

DOI

10.1111/petr.70294

Abstract

BACKGROUND: Diffuse infantile hepatic hemangiomas can lead to complications such as high-output heart failure, hypothyroidism, abdominal compartment syndrome, and hepatic failure. Medical management with propranolol is first-line therapy; however, treatment failure may occur in severe cases. METHODS: We described the case of a 2-month-old male with multiple cutaneous infantile hemangiomas and diffuse hepatic hemangiomas who presented with acute liver failure and cardiorespiratory insufficiency despite optimal treatment with propranolol. The patient was urgently listed for liver transplantation with a Pediatric End-Stage Liver Disease (PELD) score of 23 and weight < 5 kg. The infant underwent orthotopic liver transplantation from a deceased donor with caval replacement. RESULTS: Immunohistochemical staining of the liver and adrenal lesions was diffusely and strongly positive for GLUT1, consistent with infantile hemangioma. Liver function labs normalized immediately post-operatively without perioperative complications or rejection. The patient is growing and developing normally at 10 months after transplant. CONCLUSIONS: This case highlights liver transplantation as a definitive treatment for hemangioma-related acute liver failure when propranolol therapy fails. Timely referral for transplantation is critical in optimizing outcomes in this rare but severe condition.

APA Citation

Kleinman, Elana P.; Yazigi, Nada A.; Rumbo, Carolina; Aljuaid, Roaa A.; Ekong, Udeme D.; Khan, Khalid M.; Kallakury, Bhaskar V.; Kirkorian, Anna Yasmine; Cotton, Colleen H.; Srivastava, Radhika; Weaver, Kelly M.; Clayton, Julia; Eaton, Michelle; Gupta, Piyush; Nguyen, Brian M.; Hauser, Gabriel J.; Matsumoto, Cal S.; and Gondolesi, Gabriel E., "Liver Transplantation for Diffuse Infantile Hepatic Hemangioma and Acute Liver Failure: A Case Report" (2026). GW Authored Works. Paper 8959.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/8959

Department

Dermatology