A malignant hyperthermialike episode in a liver transplant recipient

We report a case of malignant hyperthermialike syndrome in a living-donor liver transplant recipient with no familial history of malignant hyperthermia or exposure to known triggering drugs. The patient showed many features of a typical malignant hyperthermia episode, and The Clinical Grading Scale defined this case as almost certain to be an episode of malignant hyperthermia (rank 5). However, the diagnosis was questionable. The intraoperative and perioperative periods during liver transplant can involve drastic alterations of physiological parameters, which can make malignant hyperthermia difficult to diagnosis. The data we obtained using a pulmonary artery catheter suggest an intraoperative increase in systemic oxygen consumption.