Korean J Anesthesiol.  2003 Feb;44(2):271-277. 10.4097/kjae.2003.44.2.271.

Fatal Pulmonary Hemorrhage after Reperfusion of a Grafted Liver: A case report

• Shin JW
• Kwon TY
• Ham KD
• Park SJ
• Hwang KS
• Choi KT

• KMID: 1936003
• DOI: http://doi.org/10.4097/kjae.2003.44.2.271

Abstract

We report a case of fatal pulmonary hemorrhage developed after reperfusion of grafted liver during a living-related liver transplantation. A 53 year-old man who had hepatic encephalopathy grade 4 with fulminant hepatic failure was scheduled for a living-related liver transplantation. Preoperative evaluation showed fever, hypoxia, hypotension, pneumonia, and pulmonary edema. Cardiopulmonary stability was maintained with oxygen therapy and inotropic agents. During the anhepatic period, the patient's vital signs remained stable with inotropic agents except one episode of sudden hypotension presumably due to right heart strain. However, hypoxia, acidosis, and electrolyte imbalance were becoming worsen in spite of variable treatments for correction. Immediately after reperfusion, a sudden increase of central venous pressure and pulmonary artery pressure was noticed. evere bradyarrhythmia, hypotension, hemoptysis, hypoxia, and acidosis were followed by cardiac arrest. Cardiopulmonary resuscitation was not successful and the patient expired

Keyword

Edema; hemorrhage; liver; lung; transplantation

MeSH Terms

Acidosis
Anoxia
Bradycardia
Cardiopulmonary Resuscitation
Central Venous Pressure
Edema
Fever
Heart
Heart Arrest
Hemoptysis
Hemorrhage*
Hepatic Encephalopathy
Humans
Hypotension
Liver Failure, Acute
Liver Transplantation
Liver*
Lung
Middle Aged
Oxygen
Pneumonia
Pulmonary Artery
Pulmonary Edema
Reperfusion*
Transplantation
Transplants*
Vital Signs
Oxygen