Role of liver transplantation in acute liver failure due to exertional heat stroke

Abstract

Background: Exertional heat stroke is a life-threatening condition characterized by hyperthermia and multisystem organ failure. This includes central nervous system dysfunction, rhabdomyolysis and renal failure, disseminated intravascular coagulation and acute liver failure. It is well established that liver transplantation is a lifesaving procedure for patients with acute liver failure however standard criteria has not been established for transplanting patients with acute liver failure in the setting of exertional heat stroke. Herein we report a series of four patients presenting with acute liver failure in the setting of exertional heat stroke of which three underwent liver transplantation. Our aim is to define the profile of patients to be considered for liver transplantation, timing to surgery and predictors of morbidity and mortality following transplantation. This will allow for improved selection of patients who may benefit from liver transplantation in the setting of exertional heat stroke.