Nodular regenerative hyperplasia: a controversial indication for orthotopic liver transplantation

Hazem A. Elariny, Solly S. Mizrahi, Daniel H. Hayes, J. Philip Boudreaux, John L. Hussey, Gist H. Farr

Research output: Contribution to journalArticlepeer-review

28 Scopus citations


Nodular regenerative hyperplasia of the liver is an uncommon cause of portal hypertension. Patients with nodular regenerative hyperplasia have signs and symptoms of portal hypertension, without evidence of hepatocellular failure or encephalopathy. We report the case of a 44-year-old woman with recurrent esophageal bleeding and refractory ascites who had a history of hemosiderosis, hepatitis C, and chronic renal allograft rejection. Our preoperative diagnosis was cirrhotic end-stage liver disease and end-stage renal disease for which the patient underwent combined hepatic and renal transplantation. Her portal hypertension symptoms resolved, and her renal function has been normal for 18 months of follow-up. Histologic examination of the liver revealed nodular regenerative hyperplasia, and a review of the literature regarding the surgical management of patients with nodular regenerative hyperplasia revealed that various shunting procedures are generally recommended. After the failure of medical management in patients with nodular regenerative hyperplasia, portosystemic shunting may be indicated before proceeding to hepatic transplantation.

Original languageEnglish
Pages (from-to)309-313
Number of pages5
JournalTransplant International
Issue number4
StatePublished - 1 Jul 1994
Externally publishedYes


  • Liver transplantation, nodular regenerative hyperplasia
  • Nodular regenerative hyperplasia, liver transplantation

ASJC Scopus subject areas

  • Transplantation


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