Increased hepatic
iron load in extrahepatic organs of cirrhotic patients with and without hereditary
hemochromatosis portends a poorer long term prognosis after
liver transplant. Hepatic as well as nonhepatic
iron overload is associated with increased infectious and postoperative complications, including cardiac dysfunction. In this case report, we describe a cirrhotic patient with
alpha 1 antitrypsin deficiency and nonhereditary
hemochromatosis (non-HFE) that developed
cardiogenic shock requiring mechanical circulatory support for twenty days after
liver transplant. Upon further investigation, she was found to have significant
iron deposition in both the liver and heart biopsies. Her heart regained complete and sustained recovery following ten days of mechanical biventricular support. This case highlights the importance of preoperatively recognizing extrahepatic
iron deposition in patients referred for
liver transplantation irrespective of etiology of
liver disease as this may prevent postoperative complications.