Rare causes of hyperbilirubinemia after lung transplantation: our experience at a single center

Abstract

Causes of hyperbilirubinemia after lung transplantation are varied, and the prognosis of patients with hyperbilirubinemia arising from rare causes was poor. Therefore, early evaluation and management of hyperbilirubinemia after lung transplantation is important to improve patient outcomes.

Radiological patterns of secondary sclerosing cholangitis in patients after lung transplantation

“…As lung transplantation has become more widespread, several complications after lung transplantation have been reported [10][11][12][13]. Recently, we have encountered cases of SSC after lung transplants in our center.…”

“…Lung transplantation is the best treatment for patients with end stage pulmonary disease, and the number of lung transplantations has steadily increased [10][11][12][13].…”

A review of liver dysfunction in the lung transplant patient

“…Due to lack of consensus in the thoracic transplant literature, work to build a standardized, reproducible definition of postoperative liver dysfunction remains an area of active investigation. [5][6][7] No comprehensive definition currently exists for liver dysfunction in the Additionally, MELD scoring and its variations for anticoagulated patients may be used to identify abnormalities in liver function. 37,38 While still a powerful tool, the efficacy of MELD in predicting the progression of liver disease following lung transplantation remains to be investigated.…”

“…Chan et al 5 reported incidence of hepatic injury/disease by ICD-9 code designation at 6.9% in the postoperative period with 1-, 3-, and 5- Expanded use of cardiopulmonary bypass (CPB) may be associated with development of post-transplant hypoxic hepatitis. 6,39 Catecholamine release following induction of CPB results in up to a 45% reduction in hepatic arterial blood flow and a 20% decrease in hepatic perfusion. 40 The increased hepatic metabolic and physiological demand associated with CPB combined with poor perfusion may overwhelm hepatic protective mechanisms and contribute to the progression of liver disease.…”

“…Postoperative liver dysfunction is a particularly devastating and ill-defined postoperative complication following lung transplantation. The wide range in reported incidence of 6.9%-28.4% [5][6][7] in the current literature reflects the lack of available data and the variance in definitions used. The current etiological hypothesis explaining liver dysfunction post-transplant suggests that prolonged hypoxemia, oxidative stress from hemodynamic support systems, and hepatotoxic medications collectively overwhelm protective hepatocellular mechanisms, resulting in hepatocyte injury and progressive liver failure.…”