No abstract

No abstract

Abbreviations & Acronyms BMI = body mass index ECUD = extracorporeal urinary diversion HR = hazard ratio ICG = indocyanine green ICUD = intracorporeal urinary diversion IQR = interquartile range ORC = open radical cystectomy RARC = robot-assisted radical cystectomy RC = radical cystectomy STROBE = Strengthening the Reporting of Observational Studies in Epidemiology Ta = non-invasive papillary carcinoma Tis = carcinoma in situ UES = ureteroenteric stricture

Increasing experience has fostered the acceptance of liver transplantation as a treatment for patients with hepatopulmonary syndrome. Morbidity and mortality is most commonly attributed to progressive arterial hypoxemia postoperatively. A cerebral hemorrhage has been reported in one patient with hepatopulmonary syndrome after transplantation. However, a postmortem examination of the brain was not performed and the pathogenesis or type of cerebral hemorrhage was undefined. We report on a patient with severe hepatopulmonary syndrome who developed multiple intracranial hemorrhages after transplantation. The intracerebral hemorrhages were most consistent with an embolic etiology on postmortem examination. We postulate that venous embolization, caused by the manipulation of a Swan Ganz catheter in a thrombosed central vein, resulted in pulmonary emboli that passed through dilated intrapulmonary vessels into the cerebral microcirculation. Special attention to central venous catheters and avoidance of manipulation may be warranted in subjects with severe hepatopulmonary syndrome after liver transplantation.

No abstract