Postoperative Liver Failure Secondary to Hypoxic Hepatitis in Double Lung Transplantation: A Case Report

Hypoxic hepatitis is a diagnosis of exclusion that should be suspected in patients with systemic hypoperfusion risk factors. It has a very high mortality, close to 50%. Although respiratory fail-ure has been described as an etiologic factor for hypoxic hepatitis, cases of liver failure secondary to hypoxic hepatitis after lung transplantation have not been reported. Here we describe the case of a 54-year-old patient who underwent double lung transplantation with intraoperative ECMO and presented postoperative liver failure with a fatal outcome, despite adequate functioning of the lung graft. We describe the clinical presentation, risk factors, intra-and postoperative course, diagnosis, and the importance of pretransplant assessment, along with a review of the literature.

Automated summary

This case report highlights the importance of recognizing and diagnosing hypoxic hepatitis in patients with systemic hypoperfusion risk factors, even after lung transplantation. The study emphasizes the high mortality rate associated with this condition and the lack of reported cases of liver failure secondary to hypoxic hepatitis after lung transplantation.