Liver transplantation (LT) is an effective treatment option in patients with Budd-Chiari syndrome and end-stage liver disease. However, the procedure may lead to a sudden increase in cardiac preload, which in turn may cause heart failure. Although assays of B-type natriuretic peptide (BNP) are increasingly used in diagnosis, management, and prediction of heart failure, the role of BNP after LT has not been well defined. Herein, we describe the case of a 56-year-old woman with Budd-Chiari syndrome who underwent LT and in whom heart failure was successfully managed using serial monitoring of BNP concentrations. The BNP concentration increased to 1735 pg/mL on postoperative day 4, and decreased to 180 pg/mL on postoperative day 19, at which time inotropic agents were discontinued.
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