Re-Expansion Pulmonary Edema vs Alveolar-Pleural Fistula During Liver Transplant: Diagnosis and Management

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Conference Proceeding

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A 46-year-old man with a history of nonalcoholic fatty liver cirrhosis and acute kidney injury secondary to hepatorenal syndrome presented for liver transplant. The patient had a right hepatic hydrothorax with a Pleurx catheter placement and had been draining 500cc fluid three-times per week prior to surgery. Prior to induction, the catheter drained out 1L of fluid which progressed to 300cc of frothy yellow/brown secretions after induction and resulted in 14L in total throughout the operative period. This case will be used to discuss an algorithm for diagnosing re-expansion pulmonary edema and alveolar-pleural fistula while proposing management of both scenarios.


American Society of Anesthesiologists Annual Meeting, October 12-16, 2023, San Francisco, CA