Cardiac Failure after Liver Transplantation Requiring a Biventricular Assist Device

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, incl...

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Bibliographic Details
Main Authors: Rita Jermyn, Eiei Soe, David D’Alessandro, Julia Shin, William Jakobleff, Daniel Schwartz, Milan Kinkhabwala, Paul J. Gaglio
Format: Article
Language:English
Published: Wiley 2014-01-01
Series:Case Reports in Transplantation
Online Access:http://dx.doi.org/10.1155/2014/946961
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Summary: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.
ISSN:2090-6943
2090-6951