Acute liver failure following hemodialysis arteriovenous graft placement: a case reportReport as inadecuate




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Journal of Medical Case Reports

, 4:261

First Online: 10 August 2010Received: 23 October 2009Accepted: 10 August 2010DOI: 10.1186-1752-1947-4-261

Cite this article as: Brener, Z.Z., Paiusco, A.D. & Bergman, M. J Med Case Reports 2010 4: 261. doi:10.1186-1752-1947-4-261

Abstract

IntroductionSevere high-output cardiac failure is a serious complication of high-flow vascular access requiring immediate intervention. Ischemic hepatitis is defined as a massive increase in serum transaminase levels due to an imbalance between hepatic oxygen supply and demand in the absence of other acute causes of liver damage. It is typically preceded by hypotension, hypoxemia, or both, and occurs mostly in elderly patients with right-sided congestive heart failure.

Case presentationWe report a fatal case of acute liver failure in an 84-year-old Caucasian man with high-output cardiac failure due to arteriovenous hemodialysis access. The chronological sequence of acute liver failure in the context of vascular access created two days before suggests that ischemic hepatitis was the result of high-output cardiac failure due to vascular access.

ConclusionsA thorough cardiac assessment should be performed in patients with severe cardiac disease prior to placing an arteriovenous access, and arteriovenous fistula should be the preferred vascular access.

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Author: Zachary Z Brener - Augusto D Paiusco - Michael Bergman

Source: https://link.springer.com/



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