Background : Unquestionably, infection control is critical in the pre- and post-transplantation phases because of the need for postoperative immunosuppressant use. Lymphorrhea, with prominent lymphatic leakage from the affected area as well as intractable infection, is considered the most severe form of lymphedema. A female patient with Child C HCV-related liver cirrhosis complicated by portal vein thrombosis (PVT), left lower leg lymphorrhea, and recurrent cellulitis will be presented. To the best of our knowledge, this is the first report of liver cirrhosis complicated by lower limb lymphorrhea before transplantation.

Methods : This report details a 50-year-old female patient who was diagnosed with Child C HCV-related liver cirrhosis, along with portal vein thrombosis, left lower leg lymphorrhea, and recurrent cellulitis. The patient was able to undergo a successful deceased donor liver transplantation (DDLT) eventually after undergoing supermicrosurgical lymphaticovenous anastomoses (LVA) to address her lymphorrhea and infection issues.

Results : Despite facing numerous challenges, including an initial delay in transplantation due to lymphorrhea and ongoing infection in her left lower leg, as well as deteriorating conditions such as hepatic coma, infected ascites, and biliary tract infection before transplantation, the patient achieved successful recovery with satisfactory graft function and was free from lymphedema/lymphorrhea in her left lower limb three years post-transplantation.

Conclusions : The present case exemplifies the significance of interdisciplinary consultation and collaboration for the timely and effective treatment of complicated patients.