Ductular cholestasis, an unusual form of intrahepatic cholestasis, associated with cardiogenic shock and ventricular assist device.

Abstract:

:Ventricular assist devices have been shown to be effective in advanced heart failure selected patients. They often have borderline end-organ function, what facilitates organ dysfunction. Liver failure is difficult to manage and leads to increased morbidity and mortality. We report a case of ductular cholestasis, an unusual cholestatic hepatic failure with untractable coagulopathy, developed during the use of a magnetic levitation centrifugal pump, implanted as a bridge to heart transplantation, in a patient with cardiogenic shock (as an end-stage disease of idiopathic dilated cardiomyopathy). We discussed the pathophysiology of this entity and the possible related factors, including the assist device. Preemptive interventions have been advocated as the primary way of treatment. Preoperative optimization of heart function and avoidance of visceral hypoperfusion and sepsis may play a major role.

journal_name

Artif Organs

journal_title

Artificial organs

authors

Mohedano-Gómez A,Pérez-Vela JL,Renes-Carreño E,De-Andrés CI,Corres-Peiretti MA,Arribas-López P,Gutierrez-Rodriguez J,Perales-Rodríguez-De-Viguri N

doi

10.1111/j.1525-1594.2009.00760.x

subject

Has Abstract

pub_date

2010-02-01 00:00:00

pages

149-52

issue

2

eissn

0160-564X

issn

1525-1594

pii

AOR760

journal_volume

34

pub_type

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