title: Liver transplantation in exertional heat stroke: a medical dilemma.
abstract: BACKGROUND
  Exertional heat stroke (EHS) is a life-threatening condition caused by an extreme elevation in core body temperature. Hepatic involvement is one of the hallmarks of heat stroke, affecting nearly all heat stroke patients. It is usually manifested by increased serum levels of liver enzymes, but acute liver failure has also been reported. Liver transplantation has been proposed as a potential treatment in cases of severe liver failure, but there are no unanimous criteria pointing to the right stage in which to conduct the transplantation.
  
  
  METHODS
  We report a case of an 18-year old patient who suffered heat-induced liver failure. The patient was referred for orthotopic liver transplantation (OLT) but spontaneously recovered completely with conservative treatment.
  
  
  CONCLUSIONS
  This case demonstrates the complexity of the decision for liver transplantation in EHS. The various prognostic criteria of acute hepatic failure and their relevance to EHS are critically reviewed, with an aim to assess their application for such a condition.
authors.affiliation: Heller Institute of Medical Research, Sheba Medical Center, 52621 Tel Hashomer, Israel.
authors.forename: Eran
authors.initials: E
authors.lastname: Hadad
authors.forename: Ziv
authors.initials: Z
authors.lastname: Ben-Ari
authors.forename: Yuval
authors.initials: Y
authors.lastname: Heled
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Moran
authors.forename: Yoav
authors.initials: Y
authors.lastname: Shani
authors.forename: Yoram
authors.initials: Y
authors.lastname: Epstein
mesh_terms: D000328:Adult; D005716:Game Theory; D018883:Heat Stroke / Q000150:complications* / Q000628:therapy; D006801:Humans; D017114:Liver Failure, Acute / Q000209:etiology* / Q000628:therapy; D016031:Liver Transplantation / Q000592:standards*; D008297:Male; D016896:Treatment Outcome