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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| Format: | Article |
| Language: | English |
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Wiley
2014-01-01
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| Series: | Case Reports in Transplantation |
| Online Access: | http://dx.doi.org/10.1155/2014/946961 |
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| author | Rita Jermyn Eiei Soe David D’Alessandro Julia Shin William Jakobleff Daniel Schwartz Milan Kinkhabwala Paul J. Gaglio |
| author_facet | Rita Jermyn Eiei Soe David D’Alessandro Julia Shin William Jakobleff Daniel Schwartz Milan Kinkhabwala Paul J. Gaglio |
| author_sort | Rita Jermyn |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-500542c060934df3902adf59eafdd5e8 |
| institution | Kabale University |
| issn | 2090-6943 2090-6951 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Transplantation |
| spelling | doaj-art-500542c060934df3902adf59eafdd5e82025-02-03T00:59:45ZengWileyCase Reports in Transplantation2090-69432090-69512014-01-01201410.1155/2014/946961946961Cardiac Failure after Liver Transplantation Requiring a Biventricular Assist DeviceRita Jermyn0Eiei Soe1David D’Alessandro2Julia Shin3William Jakobleff4Daniel Schwartz5Milan Kinkhabwala6Paul J. Gaglio7Division of Heart Failure, Department of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USADivision of Hepatology, Department of Gastroenterology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USADepartment of Cardiothoracic Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USADivision of Heart Failure, Department of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USADepartment of Cardiothoracic Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USADepartment of Pathology, Montefiore Medical Center, USADivision of Hepatology, Department of Gastroenterology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USADivision of Hepatology, Department of Gastroenterology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USAIncreased 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.http://dx.doi.org/10.1155/2014/946961 |
| spellingShingle | Rita Jermyn Eiei Soe David D’Alessandro Julia Shin William Jakobleff Daniel Schwartz Milan Kinkhabwala Paul J. Gaglio Cardiac Failure after Liver Transplantation Requiring a Biventricular Assist Device Case Reports in Transplantation |
| title | Cardiac Failure after Liver Transplantation Requiring a Biventricular Assist Device |
| title_full | Cardiac Failure after Liver Transplantation Requiring a Biventricular Assist Device |
| title_fullStr | Cardiac Failure after Liver Transplantation Requiring a Biventricular Assist Device |
| title_full_unstemmed | Cardiac Failure after Liver Transplantation Requiring a Biventricular Assist Device |
| title_short | Cardiac Failure after Liver Transplantation Requiring a Biventricular Assist Device |
| title_sort | cardiac failure after liver transplantation requiring a biventricular assist device |
| url | http://dx.doi.org/10.1155/2014/946961 |
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