Cardiac Failure after Liver Transplantation Requiring a Biventricular Assist Device

Autor: Rita Jermyn, Eiei Soe, David D’Alessandro, Julia Shin, William Jakobleff, Daniel Schwartz, Milan Kinkhabwala, Paul J. Gaglio
Jazyk: angličtina
Rok vydání: 2014
Předmět:
Zdroj: Case Reports in Transplantation, Vol 2014 (2014)
Druh dokumentu: article
ISSN: 2090-6943
2090-6951
DOI: 10.1155/2014/946961
Popis: Increased hepatic iron load in extrahepatic organs of cirrhotic patients with and without hereditary hemochromatosis portends a poorer long term prognosis after liver transplant. Hepatic as well as nonhepatic iron overload is associated with increased infectious and postoperative complications, including cardiac dysfunction. In this case report, we describe a cirrhotic patient with alpha 1 antitrypsin deficiency and nonhereditary hemochromatosis (non-HFE) that developed cardiogenic shock requiring mechanical circulatory support for twenty days after liver transplant. Upon further investigation, she was found to have significant iron deposition in both the liver and heart biopsies. Her heart regained complete and sustained recovery following ten days of mechanical biventricular support. This case highlights the importance of preoperatively recognizing extrahepatic iron deposition in patients referred for liver transplantation irrespective of etiology of liver disease as this may prevent postoperative complications.
Databáze: Directory of Open Access Journals