Transient porphyrinemia in a liver transplant recipient.
We report a case of acquired porphyrinemia in a liver transplant recipient. Thrombosis of the portal vein and hepatic artery led to massive necrosis of the patient's first donor liver, necessitating its removal. After an 18-hour anhepatic period, a second donor liver was transplanted. During this interval, the patient was warmed with an infrared heat lamp that emitted bright visible light. Following the anhepatic period, a photodistributed cutaneous erythema was noted. The level of total serum porphyrins during the anhepatic period was significantly elevated at 1.548 mumol/L (normal, less than 0.018 mumol/L). Fractionation showed that the levels of the hydrophobic porphyrins, coproporphyrin and protoporphyrin, were elevated, while the levels of the hydrophilic porphyrins remained normal. Following the successful second liver transplantation, the patient's porphyrin levels declined. This is the first reported case of acquired porphyrinemia in a liver transplant recipient.
Blemker
A L
AL
Department of Dermatology, Indiana University School of Medicine, Indianapolis 46202.
Dean
R A
RA
Weaver
D C
DC
Pescovitz
M D
MD
Filo
R S
RS
Treadwell
P
P
D002648:Child; D003306:Coproporphyrins / Q000097:blood; D006499:Hepatic Artery; D006801:Humans; D007259:Infrared Rays; D008099:Liver / Q000473:pathology; D016031:Liver Transplantation / Q000009:adverse effects; D008297:Male; D009336:Necrosis; D010787:Photosensitivity Disorders / Q000209:etiology; D011166:Porphyrins / Q000097:blood*; D011169:Portal Vein; D011524:Protoporphyrins / Q000097:blood; D013927:Thrombosis / Q000209:etiology; D013997:Time Factors
D003306:Coproporphyrins; D011166:Porphyrins; D011524:Protoporphyrins