Liver transplantation in a case of fulminant liver failure after exertion

Saissy, J. M.

doi:10.1007/bf01709530

Cited by 32 publications

(28 citation statements)

References 6 publications

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“…Acute liver failure is documented in 5% of exertional heat stroke patients with hypophosphatemia a predictive biomarker of this condition (118,189). Liver transplantation has been suggested as a potential treatment for exertional heat stroke patients although patients have succumbed despite this treatment; others with recurrent and/or extensive liver damage have displayed complete biochemical and histologic recovery without transplantation (31,33,153,154,321,358,359). Treatment of heat stroke patients with antipyretic drugs, such as acetaminophen (e.g., Tylenol) has been associated with hepatic failure and the need for liver transplantation (125,153,154,321,389).…”

Section: Liver Injurymentioning

confidence: 98%

“…Indomethacin had no effect on normal (resting) core temperature. heat stroke patients with NSAIDs, but these drugs are contraindicated for this condition due to potential toxic effects on the liver and the association of this treatment with the need for liver transplantation in some patients (125,153,154,321,389).…”

Section: Body Temperature Responsesmentioning

confidence: 99%

“…Liver transplantation has been suggested as a potential treatment for exertional heat stroke patients although patients have succumbed despite this treatment; others with recurrent and/or extensive liver damage have displayed complete biochemical and histologic recovery without transplantation (31,33,153,154,321,358,359). Treatment of heat stroke patients with antipyretic drugs, such as acetaminophen (e.g., Tylenol) has been associated with hepatic failure and the need for liver transplantation (125,153,154,321,389). The benefit of liver transplantation for exertional heat stroke patients remains controversial due to poor and limited results of the procedure; therefore, proper interpretation of prognostic criteria is crucial before considering a patient for this surgical intervention as reviewed in (140).…”

Section: Liver Injurymentioning

confidence: 99%

“…Fever is also observed in heat stroke patients and animal models during the days and weeks of recovery and is regarded as a response to endotoxin leakage from damaged gut membranes (212,213,238). Physicians have attempted to alleviate fever to heat stroke using the administration of nonsteroidal anti-inflammatory drugs (NSAIDs), but there is currently no scientific evidence to support a role for the cyclooxygenase pathway (the targets of NSAIDs inhibition) in mediation of this response (34,248,321).…”

Section: Physiological Temperature Regulationmentioning

confidence: 99%

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Heat Stroke

Leon

Bouchama

2015

Comprehensive Physiology

360

356

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Heat stroke is a life-threatening condition clinically diagnosed as a severe elevation in body temperature with central nervous system dysfunction that often includes combativeness, delirium, seizures, and coma. Classic heat stroke primarily occurs in immunocompromised individuals during annual heat waves. Exertional heat stroke is observed in young fit individuals performing strenuous physical activity in hot or temperature environments. Long-term consequences of heat stroke are thought to be due to a systemic inflammatory response syndrome. This article provides a comprehensive review of recent advances in the identification of risk factors that predispose to heat stroke, the role of endotoxin and cytokines in mediation of multi-organ damage, the incidence of hypothermia and fever during heat stroke recovery, clinical biomarkers of organ damage severity, and protective cooling strategies. Risk factors include environmental factors, medications, drug use, compromised health status, and genetic conditions. The role of endotoxin and cytokines is discussed in the framework of research conducted over 30 years ago that requires reassessment to more clearly identify the role of these factors in the systemic inflammatory response syndrome. We challenge the notion that hypothalamic damage is responsible for thermoregulatory disturbances during heat stroke recovery and highlight recent advances in our understanding of the regulated nature of these responses. The need for more sensitive clinical biomarkers of organ damage is examined. Conventional and emerging cooling methods are discussed with reference to protection against peripheral organ damage and selective brain cooling.

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Section: Liver Injurymentioning

confidence: 98%

Section: Body Temperature Responsesmentioning

confidence: 99%

Section: Liver Injurymentioning

confidence: 99%

Section: Physiological Temperature Regulationmentioning

confidence: 99%

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Heat Stroke

Leon

Bouchama

2015

Comprehensive Physiology

360

356

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“…Liver dysfunction may also contribute to increased circulating endotoxin levels due to the important bacterial clearance function of this organ (67). Unfortunately, many heat stroke patients require liver transplantation, and the use of antipyretic drugs, such as acetaminophen, has been associated with failure of this organ (33,39,40,75,83).…”

Section: The Systemic Inflammatory Responsementioning

confidence: 99%