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British Journal of Anaesthesia, 2001, Vol. 86, No. 3 431-434
© 2001 The Board of Management and Trustees of the British Journal of Anaesthesia

Liver transplantation for massive hepatic haemangiomatosis causing restrictive lung disease

M. T. Keegan1, G. S. Kamath1, G. M. Vasdev1, J. Y. Findlay1, G. J. Gores2, J. L. Steers3 and D. J. Plevak1

Departments of 1Anesthesiology and Critical Care, 2Gastroenterology and Hepatology, and 3Transplantation Surgery, Mayo Clinic, Rochester, MN 55905, USA*Corresponding author

A 34-yr-old man with hepatic haemangiomatosis presented for orthotopic liver transplantation. His massively distended abdomen caused thoracic compression and severe restrictive lung disease. Respiratory failure was the principal indication for transplantation. Increased airway pressures, pulmonary hypertension, systemic hypotension caused by aorto-caval compression, and blood loss, complicated the intra-operative anaesthetic management. Weaning from mechanical ventilation was impaired by acute and chronic metabolic alkalosis, and diaphragmatic laxity.

Br J Anaesth 2000; 86: 431–4


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