Desflurane-induced acute  liver failure

Chin, Marcus W; Njoku, Dolores B; MacQuillan, Gerard; Cheng, Wendy S; Kontorinis, Nickolas

doi:10.5694/j.1326-5377.2008.tb02035.x

Topics

To the Editor: It has been well established that traditional inhalational anaesthetic agents can cause mild and sometimes fulminant liver failure.1 However, while newer inhalational agents are a theoretical cause of hepatotoxicity, such cases have rarely been reported.2,3

1 Department of Gastroenterology and Hepatology, Royal Perth Hospital, Perth, WA.
2 Johns Hopkins University, Baltimore, Md, USA.
3 Department of Gastroenterology and Hepatology, Sir Charles Gairdner Hospital, Perth, WA.

Correspondence: marcus.chin@health.wa.gov.au

1. Bunker JP. Final report of the National Halothane Study. Anesthesiology 1968; 29: 231-232.
2. Tung D, Yoshida EM, Wang CS, Steinbrecher UP. Severe desflurane hepatotoxicity after colon surgery in an elderly patient. Can J Anaesth 2005; 52: 133-136.
3. Berghaus TM, Baron A, Geier A, et al. Hepatotoxicity following desflurane anesthesia. Hepatology 1999; 29: 613-614.
4. Njoku D, Laster MJ, Gong DH, et al. Biotransformation of halothane, enflurane, isoflurane, and desflurane to trifluoroacetylated liver proteins: association between protein acylation and hepatic injury. Anesth Analg 1997; 84: 173-178.
5. Njoku DB, Mellerson JL, Talor MV, et al. Role of CYP2E1 immunoglobulin G4 subclass antibodies and complement in pathogenesis of idiosyncratic drug-induced hepatitis. Clin Vaccine Immunol 2006; 13: 258-265.

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