Department of Surgery, Division of Organ Transplantation
Digestive System Diseases | Surgery | Surgical Procedures, Operative
Heat stroke is a multiple organ dysfunction syndrome of poorly understood pathogenesis. Exertional heat stroke with acute liver failure is a rarely reported condition. Liver transplant has been recommended as treatment in cases of severe liver dysfunction; however, there are only 5 described cases of long-term survival after this procedure in patients with heat stroke. Here, we present 2 cases of young athletes who developed heat stroke. Both patients developed acute liver failure and were listed for liver transplant. Liver function tests of one patient improved, and he was discharged on postoperative day 13. The other patient showed no signs of improvement and liver biopsy showed massive necrosis. The patient underwent combined kidney-liver transplant and was discharged on postoperative day 17. After a follow-up of longer than 6 years, both patients are doing well with normal liver function and no neurologic sequelae. We also reviewed all published cases of hepatic failure associated with heat stroke and found 9 published cases of liver transplant for heat stroke in the English literature. Conservative management appears to be justified in heat stroke-associated liver failure, even in the presence of accepted criteria for emergency liver transplant.
Acute liver failure, Emergency liver transplant, Elevated body temperature, Exertional heat stroke, Heat shock, Heat stroke-associated liver failure
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Copyright © Başkent University 2018
DOI of Published Version
Exp Clin Transplant. 2018 Aug 17. doi: 10.6002/ect.2018.0003. Link to article on publisher's site
Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation
Martins, Paulo N.A.; Bruggenwirth, Isabel M. A.; McDaid, James; Hertl, Martin; Kawai, Tatsuo; Elias, Nahel; Chung, Raymond T.; and Markmann, James F., "Heat Stroke as a Cause of Liver Failure and Evaluation of Liver Transplant" (2018). Open Access Articles. 3589.