Liver transplantation for massive hepatic haemangiomatosis causing restrictive lung disease

• Published in: British journal of anaesthesia : BJA Vol. 86; no. 3; pp. 431 - 434
• Main Authors: Keegan, M.T., Kamath, G.S., Vasdev, G.M., Findlay, J.Y., Gores, G.J., Steers, J.L., Plevak, D.J.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.03.2001; Oxford University Press; Oxford Publishing Limited (England)
• Subjects: Abdominal surgery. Urology. Gynecology. Obstetrics; Adult; Anesthesia; Anesthesia depending on type of surgery; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Follow-Up Studies; Hemangioma - complications; Hemangioma - surgery; Humans; Liver Neoplasms - complications; Liver Neoplasms - surgery; Liver Transplantation; liver, haemangiomatosis; lung, diseases; Male; Medical sciences; Respiratory Insufficiency - etiology; lung, diseases; liver, haemangiomatosis; liver, transplantation; liver, transplantation; liver, haemangiomatosis; lung, diseases; Human; Respiratory disease; Liver; Cardiovascular disease; General anesthesia; Hepatic disease; Transplantation; Vascular disease; Case study; Orthotopic transplantation; Angioma; Respiratory failure; Digestive diseases; Complication
• ISSN: 0007-0912; 1471-6771
• DOI: 10.1093/bja/86.3.431

A 34-yr-old man with hepatic haemangiomatosis presented for orthotopic liver transplantation. His massively distended abdomen caused thoracic compression and severe restrictive lung disease. Respiratory failure was the principal indication for transplantation. Increased airway pressures, pulmonary hypertension, systemic hypotension caused by aorto-caval compression, and blood loss, complicated the intra-operative anaesthetic management. Weaning from mechanical ventilation was impaired by acute and chronic metabolic alkalosis, and diaphragmatic laxity.