UMMS Affiliation

Department of Surgery, Division of Organ Transplantation

Publication Date


Document Type



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

Rights and Permissions

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

Journal/Book/Conference Title

Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation

Related Resources

Link to Article in PubMed

PubMed ID