Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2018.01.017
Brazilian Journal of Anesthesiology
Clinical Information

Fulminant hepatic failure after simultaneous kidney-pancreas transplantation: a case report

Insuficiência hepática fulminante após transplante simultâneo de rim-pâncreas: um relato de caso

Jimmy L. Moss; Benjamin W. Brown; Sher-Lu Pai; Klaus D. Torp; Stephen Aniskevich

http://dx.doi.org/10.1016/j.bjane.2018.01.017 Braz J Anesthesiol, vol.68, n5, p.535-538, 2018
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Abstract

Abstract We describe an unusual case of hyperacute hepatic failure following general anesthesia in a patient receiving a simultaneous kidney-pancreas transplant. Despite an aggressive evaluation of structural, immunological, viral, and toxicological causes, a definitive cause could not be elucidated. The patient required a liver transplant and suffered a protracted hospital course. We discuss the potential causes of fulminant hepatic failure and the perioperative anesthesia management of her subsequent liver transplantation.

Keywords

Liver failure, Kidney-pancreas transplant, Volatile agents, Liver transplant, Drug reaction, Isoflurane toxicity, Adverse drug reaction, Inhalational anesthesia

Resumo

Resumo Descrevemos um caso incomum de insuficiência hepática hiperaguda após a anestesia geral em uma paciente que recebeu um transplante simultâneo de rim-pâncreas. Apesar de uma avaliação agressiva das causas estruturais, imunológicas, virais e toxicológicas, uma causa definitiva não pôde ser identificada. A paciente precisou de um transplante de fígado que resultou em prolongamento da internação hospitalar. Discutimos as potenciais causas da insuficiência hepática fulminante e o manejo da anestesia no período perioperatório de seu subsequente transplante de fígado.

Palavras-chave

Insuficiência hepática, Transplante de rim-pâncreas, Agentes voláteis, Transplante de fígado, Reação medicamentosa, Toxicidade por isoflurano, Reação medicamentosa adversa, Anestesia inalatória

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