title: Living donor liver transplantation with noninvasive ventilation for exertional heat stroke and severe rhabdomyolysis.
abstract: A 16-year-old male with exertional heat stroke (EHS) had extensive hepatocellular damage, severe rhabdomyolysis, renal failure, and coma. Hemodiafiltration was started on day 2 and living donor liver transplantation was performed on day 3. He received continuous mechanical ventilation with intubation before and after the surgery. As his mental status improved, he could not tolerate intubation, and he was extubated on postoperative day (POD) 26. He received facial noninvasive positive pressure ventilation until POD 50. Hemodiafiltration was discontinued on POD 52. He was discharged on POD 67 and is currently well more than a year after transplantation. A literature search indicates that this patient is the first long-term survivor (>1 year) after liver transplantation for exertional heat stroke.
authors.affiliation: Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto University Hospital, Kyoto, Japan.
authors.forename: Ken-ichi
authors.initials: K
authors.lastname: Takahashi
authors.forename: Kazuo
authors.initials: K
authors.lastname: Chin
authors.forename: Kohei
authors.initials: K
authors.lastname: Ogawa
authors.forename: Mureo
authors.initials: M
authors.lastname: Kasahara
authors.forename: Takanori
authors.initials: T
authors.lastname: Sakaguchi
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hasegawa
authors.forename: Kensuke
authors.initials: K
authors.lastname: Sumi
authors.forename: Takaya
authors.initials: T
authors.lastname: Nakamura
authors.forename: Akira
authors.initials: A
authors.lastname: Tamaki
authors.forename: Michiaki
authors.initials: M
authors.lastname: Mishima
authors.forename: Takashi
authors.initials: T
authors.lastname: Nakamura
authors.forename: Koichi
authors.initials: K
authors.lastname: Tanaka
mesh_terms: D000293:Adolescent; D005538:Football; D018883:Heat Stroke / Q000150:complications*; D006801:Humans; D017114:Liver Failure, Acute / Q000209:etiology* / Q000601:surgery*; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D005082:Physical Exertion; D011175:Positive-Pressure Respiration; D012206:Rhabdomyolysis / Q000150:complications*; D012720:Severity of Illness Index