Document Detail


Temporary cardiac pacing for fatal arrhythmia in living-donor liver transplantation: three case reports.
MedLine Citation:
PMID:  18929869     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Cardiac pacing often turns out to be the only effective treatment of severe, life-threatening arrhythmias. We performed 77 living-donor liver transplantations (LDLT) from 1999 to 2007. In these cases, three recipients experienced fatal arrhythmia and required temporary cardiac pacing during the perioperative period. The first case was a 68-year-old woman diagnosed with liver cirrhosis and hepatocellular carcinoma (HCC). Her Model for End-Stage Liver Disease (MELD) score was 34. We performed LDLT using a right lobe graft. She showed complete atrioventricular block with cardiac arrest at postoperative day (POD) 42 after a bacterial infection. We performed a resuscitation and instituted temporary cardiac pacing. However, she was dead at POD 43. Pathologic findings at autopsy showed a diffuse myocardial abscess, which caused the fatal arrhythmia. The second case was a 58-year-old man diagnosed with HCC and liver cirrhosis; his MELD score was 9. We performed LDLT using a right lobe graft. He showed atrial fibrillation after septic shock. He also showed sinus bradycardia with a cardiac arrest at POD 10. We performed resuscitation and emergent temporary pacing. He recovered and was alive without recurrence of arrhythmia or infection. The third case was a 58-year-old woman diagnosed with multiple HCC. During preoperative regular check-up, she was diagnosed to have cardiac hypertrophy and was started on beta-blockers as treatment for cardiac hypertrophy. However, severe bradycardia necessitated temporary cardiac pacing. LDLT was performed safely after implantation of a pacemaker. Early use of temporary cardiac pacing for severe arrhythmias may be effective to maintain the hemodynamic state in LDLT.
Authors:
T Kobayashi; Y Sato; S Yamamoto; H Oya; T Takeishi; H Kokai; K Hatakeyama
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Transplantation proceedings     Volume:  40     ISSN:  0041-1345     ISO Abbreviation:  Transplant. Proc.     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-10-20     Completed Date:  2008-12-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0243532     Medline TA:  Transplant Proc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2818-20     Citation Subset:  IM    
Affiliation:
Division of Digestive and General Surgery, Niigata University Graduate School of medical and Dental Sciences, Niigata, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Arrhythmias, Cardiac / etiology*,  therapy*
Bradycardia / therapy
Carcinoma, Hepatocellular / surgery
Cardiac Pacing, Artificial / methods*
Fatal Outcome
Female
Humans
Intraoperative Complications / therapy
Liver Neoplasms / surgery
Liver Transplantation / adverse effects*
Living Donors*
Male
Middle Aged
Resuscitation
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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