Brazil						                            
                            
						
 Case Report
												Diaphragmatic Hernia after Adult Orthotopic Liver Transplantation: A Rare
Surgical Complication Associated to Immunosuppression? 						
Author(s): Klaus Steinbrück, Reinaldo Fernandes and Marcelo EnneKlaus Steinbrück, Reinaldo Fernandes and Marcelo Enne             
						
												
				 Diaphragmatic Hernia (DH) after adult Orthotopic Liver Transplantation (OLT) is a rare event with only two cases reported in English literature. It is not clear if this complication is related to surgery or to immunosuppression therapy or both. We describe a well-resolved case of left-sided DH in a 43-year-old man taking Tacrolimus and mycophenolate mofetil (MMF) as immunosuppressants, 27 months after OLT. Authors from previously reported cases considered that ascites and incisional hernia, as well as Mammalian Target Of Rapamycin (mTOR) inhibitors therapy, as predisposing factors for DH development. In the case presented here, none of the possible surgical triggering factors described before were present. MMF is associated to impaired wound healing and incisional hernias, like mTOR inhibitors. Maybe minor and not evident diaphragmatic injury during hepatectomy associated to immunosup.. Read More»
				  
												DOI:
												 10.4172/2165-7920.1000644 
																	  
Journal of Clinical Case Reports received 1345 citations as per Google Scholar report