Fatal haemothorax following large-bore percutaneous cannulation before liver transplantation

Percutaneous bypass catheters are routinely used for veno-venousbypass (VVBP) during orthotopic liver transplantation (OLT).The recognized risks include bleeding, injury of vascular andnerve structures and lymphatic leakage. We describe a case wherethere were difficulties during catheterization and the patientsuffered a cardiac arrest on commencing VVBP. Post-mortem examinationrevealed the bypass catheter tip in the pleural space and alarge right haemothorax. Possible mechanisms of vascular perforationand preventative measures are discussed.