Iatrogenic aluminium toxicity is reported in a patient who underwent a
n orthotopic liver transplant and who had concomitant renal failure re
quiring hemodialysis. Following transplantation the patient developed
a metabolic encephalopathy with only mildly elevated blood ammonia con
centrations. During the period following transplantation the patient r
eceived massive infusions of albumin and was on oral feeding (vivonext
en), both of which contained aluminium, as did the dialysis fluid. Hyp
eraluminemia and profoundly elevated liver tissue aluminium concentrat
ions were observed. Treatment with desferrioxamine, a trivalent ion ch
elator, decreased the plasma aluminium concentrations with an improvem
ent in the patient's mental status.