alexa Hepatopulmonary syndrome with progressive hypoxemia as an indication for liver transplantation: case reports and literature review.


Journal of Pulmonary & Respiratory Medicine

Author(s): Krowka MJ, Porayko MK, Plevak DJ, Pappas SC, Steers JL,

Abstract Share this page

Abstract In the hepatopulmonary syndrome (HPS), a pulmonary vascular complication of liver disease, severe hypoxemia due to pulmonary vascular dilatation can be extremely debilitating. Determining whether patients with advanced liver disease and HPS should be considered for liver transplantation is difficult. We describe three patients with progressive and severe hypoxemia who underwent successful liver transplantation and had resolution of their arterial hypoxemia. In these patients, the progressive pulmonary deterioration accelerated the need and was considered an indication for liver transplantation rather than being considered an absolute or relative contraindication. In addition, we review the literature on 81 pediatric and adult patients with HPS who underwent liver transplantation and specifically highlight mortality, morbidity, syndrome resolution, and prognostic factors. Posttransplantation mortality (16\%) was associated with the severity of hypoxemia (mean arterial oxygen tension [PaO2] in 68 survivors was 54.2 +/- 13.2 mm Hg and in 13 nonsurvivors was 44.7 +/- 7.7 mm Hg; P<0.03). Patients with a pretransplantation PaO2 of 50 mm Hg or lower had significantly more frequent mortality (30\%) in comparison with those with a PaO2 greater than 50 mm Hg (4\%; P<0.02). Pulmonary recommendations that address the severity of hypoxemia and candidacy for liver transplantation are discussed. This article was published in Mayo Clin Proc and referenced in Journal of Pulmonary & Respiratory Medicine

Relevant Expert PPTs

Relevant Speaker PPTs

  • Shoude Jin
    Mechanisms of Chronic obstructive pulmonary disease and airway smooth muscle remodeling: the potential roles of Abhd2
    PDF Version
  • Alsayed Alnahal
    Urinary netrin-1 predict early ischemic acute kidney injury after cardiopulmonary bypass
    PPT Version | PDF Version
  • Ping Yang
    Chronic obstructive pulmonary disease (COPD) complicating early-stage lung cancer (LC)
    PDF Version
  • Gunilla Lindqvist
    Chronic obstructive pulmonary disease: A study of the relationship between patients’ feeling of guilt due to their belief of the disease being self inflicted
    PDF Version
  • Roger Mark Engel
    The effect of including manual therapy in the management of mild chronic obstructive pulmonary disease – a randomized controlled trial
    PDF Version
  • Rupal Patel Mansukhani
    Correlation of Medication Therapy in Chronic Obstructive Pulmonary Disease(COPD) Patients with 30-day Readmission Rates
    PPT Version | PDF Version
  • Hadeel Faisal Gad
    In-vitro analysis of cytokines responses of visceral leishmaniasis and pulmonary tuberculosis patients to homologous and heterologous antigen stimulation
    PPT Version | PDF Version
  • Shivanand Reddy
    Relation between low serum testosterone level and peripheral arterial disease in men and clinical evaluation of effect of testosterone administration
    PPT Version | PDF Version
  • Xin Wang
    IL17 Pathway Involves Moderating Pulmonary Hypertension, a common complication of COPD, in Statins Therapy in Smoking Rats
    PPT Version | PDF Version
  • Alex Bekker
    Optimal Perioperative Management of Arterial Blood Pressure. How high is high? How low is low?
    PPT Version | PDF Version

Recommended Conferences

Peer Reviewed Journals
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version