Living donor liver transplantation with noninvasive ventilation for exertional heat stroke and severe rhabdomyolysis.
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.
Takahashi
Ken-ichi
K
Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto University Hospital, Kyoto, Japan.
Chin
Kazuo
K
Ogawa
Kohei
K
Kasahara
Mureo
M
Sakaguchi
Takanori
T
Hasegawa
Satoshi
S
Sumi
Kensuke
K
Nakamura
Takaya
T
Tamaki
Akira
A
Mishima
Michiaki
M
Nakamura
Takashi
T
Tanaka
Koichi
K
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