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Ductular Cholestasis, an Unusual Form of Intrahepatic Cholestasis, Associated With Cardiogenic Shock and Ventricular Assist Device
Author(s) -
MohedanoGómez Alberto,
PérezVela José L.,
RenesCarreño Emilio,
DeAndrés Carolina Ibarrola,
CorresPeiretti María A.,
ArribasLópez Primitivo,
GutierrezRodriguez Julián,
PeralesRodríguezDeViguri Narciso
Publication year - 2010
Publication title -
artificial organs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 76
eISSN - 1525-1594
pISSN - 0160-564X
DOI - 10.1111/j.1525-1594.2009.00760.x
Subject(s) - cardiogenic shock , medicine , cholestasis , sepsis , cardiology , ventricular assist device , coagulopathy , liver transplantation , heart failure , consumptive coagulopathy , intensive care medicine , transplantation , myocardial infarction
Ventricular assist devices have been shown to be effective in advanced heart failure selected patients. They often have borderline end‐organ function, what facilitates organ dysfunction. Liver failure is difficult to manage and leads to increased morbidity and mortality. We report a case of ductular cholestasis, an unusual cholestatic hepatic failure with untractable coagulopathy, developed during the use of a magnetic levitation centrifugal pump, implanted as a bridge to heart transplantation, in a patient with cardiogenic shock (as an end‐stage disease of idiopathic dilated cardiomyopathy). We discussed the pathophysiology of this entity and the possible related factors, including the assist device. Preemptive interventions have been advocated as the primary way of treatment. Preoperative optimization of heart function and avoidance of visceral hypoperfusion and sepsis may play a major role.