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GENERAL ARTICLE

Vasoplegic Syndrome During Liver Transplantation

Zhongping Cao, MD^*, Yuqi Gao, MD, and Guocai Tao, MD^*

From the *Department of Anesthesia, The Southwest Hospital of The Third Military Medical University, Chongqing; Department of Anesthesia, The General Hospital of Shenyang Military Region, Shenyang; and Department of Pathophysiology, The Third Military Medical University, Chongqing, China.

Address correspondence and reprint requests to Guocai Tao, Department of Anesthesia, The Southwest Hospital of The Third Military Medical University, Chongqing, 400038, China. Address e-mail to 09czp{at}163.com.

A 56-yr-old woman with chronic hepatitis B and decompensated hepatic cirrhosis was treated with liver transplantation. At the beginning of the neohepatic phase, her arterial blood pressure remained at 60/40 mm Hg for approximately 40 min and did not respond to vasoconstrictive drugs. Her other clinical and laboratory values remained normal, apart from a high cardiac output and low systemic vascular resistance. This patient was diagnosed with vasoplegic syndrome and was treated with IV infusion of methylene blue (0.5 mg/kg) and norepinephrine. This report has potential significance to treatment in patients who undergo orthotopic liver transplantation.