Abstract
Question: A 42-year-old male 10 years post liver–intestine transplantation was referred from a regional hospital to our institute with unintentional weight loss (15 kg over 6 months), progressive exertional dyspnea, and what was thought to be a loud pansystolic murmur. Past medical history is significant for short bowel syndrome with total parenteral nutrition dependence complicated by intestinal failure associated liver disease, diminishing venous access, and a distant history of a right nephrectomy as a child.
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