Related Experiment Video
Updated: Mar 25, 2026
Author Spotlight: Enhancing Transplantation Research Through MicroCT Angiography in Murine Models
Published on: September 22, 2023
Disseminated Metastatic Tissue Calcification After Orthotopic Liver Transplantation: A Case Report
K Deguchi1, T Ueno1, R Matsuura1
1Department of Pediatric Surgery, Osaka University, Postgraduate School of Medicine, Osaka, Japan.
Insights
Severe hypercalcemia after liver transplantation can lead to widespread tissue calcification and heart failure. Early management of high calcium levels is crucial to prevent fatal outcomes in transplant patients.
Area of Science:
- Nephrology
- Cardiology
- Transplantation Medicine
Background:
- Hypercalcemia is a known complication post-liver transplantation.
- Disseminated tissue calcification and heart failure are rare but severe sequelae.
Observation:
- A 20-year-old male developed severe hypercalcemia after a second liver transplant.
- The patient experienced ventricular tachycardia and ultimately died from heart and liver failure.
- Histopathology confirmed systemic metastatic tissue calcification, including extensive myocardial calcification.
Findings:
- Progressive hypercalcemia was directly linked to disseminated metastatic tissue calcification.
- Massive myocardial calcification was identified as the cause of heart failure.
- The case highlights a fatal outcome of untreated hypercalcemia in a liver transplant recipient.
Implications:
- Early detection and intervention for hypercalcemia are critical in liver transplant patients.
- Aggressive management of hypercalcemia may prevent life-threatening complications like disseminated calcification and heart failure.
- This case underscores the importance of monitoring calcium levels post-transplantation.
Background:
Hypercalcemia has been observed in patients after liver transplantation. However, it is rare that the hypercalcemia induced disseminated tissue calcification and heart failure.
Case Report:
We report a rare case of heart failure caused by disseminated metastatic tissue calcification that involved extensive progressive myocardial calcification after liver transplantation. A 20-year-old man with end-stage liver disease due to biliary atresia underwent ABO-incompatible living donor liver transplantation. After successful transplantation, he suffered from antibody-mediated rejection. Subsequently, ABO-matched cadaveric liver retransplantation was successfully performed. Hypercalcemia developed gradually following the second transplantation. His serum calcium level increased to 18.3 mg/dL with sudden onset of ventricular tachycardia. Although he was resuscitated with a cardiopulmonary support device, he died of heart and liver failure. Histopathologic examination revealed systemic disseminated metastatic tissue calcification, including massive myocardial calcification.
Conclusion:
Progressive worsening of hypercalcemia resulted in disseminated metastatic tissue calcification and massive metastatic myocardial calcification, which led to heart failure after liver transplantation. Because hypercalcemia after liver transplantation can cause fatal tissue calcification, early intervention for hypercalcemia should be considered.
