A rare case report on diabetes insipidus following living donor liver transplantation in patient with alcoholic liver disease.

A rare occurrence of nephrogenic diabetes insipidus (DI) following liver transplantation despite elevated plasma antidiuretic hormone levels and normal brain imaging findings is of interest. On the sixth day post-transplantation, the patient developed polyuria, a hallmark symptom of DI, prompts a comprehensive differential diagnosis. Desmopressin therapy was initiated, leading to rapid symptom resolution and full recovery. This case underscores the diagnostic challenges of DI in liver transplant recipients, particularly in differentiating between central and nephrogenic forms. Conventional diagnostic tests for DI, like water deprivation, are not preferred in patients receiving liver transplantation. Therefore, clinical assessment, biochemical markers, and imaging play a crucial role in diagnosis. The patient was successfully managed with desmopressin, thus emphasizing the importance of early recognition of symptoms and prompt initiation of treatment to prevent complications in liver transplantation patients to ensure optimal outcomes. Thus, we show the potential for rare post-transplant complications and the need for individualized diagnostic and therapeutic strategies.