Liver transplantation in an adult patient with hepatocellular carcinoma following liver cirrhosis as a complication of the Fontan procedure -A case report

Autor: Min-kyung Cho, Ji-Hye Kwon, Mi Sook Gwak, Jae-Won Joh, JiYun Hwang, Gaab Soo Kim
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Zdroj: Anesthesia and Pain Medicine, Vol 15, Iss 4, Pp 466-471 (2020)
Druh dokumentu: article
ISSN: 1975-5171
2383-7977
DOI: 10.17085/apm.20037
Popis: Background Fontan-associated liver disease (FALD) is a hepatic disorder caused by hemodynamic changes and systemic venous congestion following the Fontan procedure. FALD includes liver cirrhosis and hepatocellular carcinoma (HCC), both of which may require liver transplantation (LT). However, the Fontan circulation, characterized by elevated central venous pressure and reduced cardiac output, is a challenging issue for surgeons and anesthesiologists. Case We report a living-donor LT for the treatment of HCC. The patient was a 24-year-old male who underwent the Fontan procedure for pulmonary atresia and right ventricle hypoplasia. We focused on maintaining enough blood volume for cardiac output without causing pulmonary edema, as the patient is not well adapted to changes in volume. Owing to a multidisciplinary approach, the surgery was successfully performed without fatal adverse events. Conclusions To our knowledge, this is the first case of isolated LT in a recipient who became an adult after having undergone the Fontan procedure.
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