RECURRENT FIVER FAILURE WITH SEVERE RHABDOMYOLYSIS AFTER LIVER-TRANSPLANTATION FOR CARBON-TETRACHLORIDE INTOXICATION

Acute liver failure due to intoxication is a rare indication for liver transplantation which a usually has a good prognosis. We herein repor t the case of a young mate, who underwent orthotopic liver transplanta tion for acute Liver failure due to carbon tetrachloride intoxication. Apart from hepatic and renal failure, the patient also developed seve re rhabdomyolysis, which has not thus far been described as a toxic ef fect of this chemical agent. Despite forced hyperventilation, which is known to be the most effective means of eliminating the specifically lipophylic agent, as well as excessive plasma exchange following intra venous administration of fat emulsions, Liver failure recurred when bl ood carbon tetrachloride concentrations were already at non-toxic leve ls. Retransplantation, of the liver together with a kidney was only te mporarily successful, since the patient died due to aspergillus sepsis . Based on this experience, we would recommend that whenever possible in. patients with carbon tetrachloride intoxication, liver transplant should be delayed until most of the toxic agent has been eliminated in . order to prevent fatal graft damage.