Frequency, Clinical Characteristics, and Respiratory Parameters of Hepatopulmonary Syndrome

Lima, Beatriz L.G.; França, Alex V.C.; Pazin-Filho, Antonio; Araújo, Whemberton M.; Martinez, José A.B.; Maciel, Benedito C.; Simões, Marcus V.; Terra-Filho, João; Martinelli, Ana L.C.
January 2004
Mayo Clinic Proceedings;Jan2004, Vol. 79 Issue 1, p42
Academic Journal
• Objectives: To determine the frequency and the clinical characteristics of hepatopulmonary syndrome (HPS) in cirrhotic candidates for orthotopic liver transplantation and to identify the major respiratory parameters predictive of the presence of changes in arterial oxygenation. • Patients and Methods: Patients underwent transthoracic contrast-enhanced echocardiography, pulmonary scintigraphy, pulmonary function test with diffusing capacity of lung for carbon monoxide (DLCO), and measurement of arterial blood gases. • Results: Fifty-six patients were studied. Twenty-five patients (45%) presented with intrapulmonary vascular dilatations, but only 9 (16%) fulfilled the criteria for HPS. The clinical or demographic characteristics considered did not differ in the patients with and without HPS. The DLCO value was significantly lower in patients with HPS (P=.01). However, 32 (80%) of 40 patients with low DLCO values did not fulfill the criteria for HPS. An alveolar arterial oxygen gradient (AaPo[sub 2]) of more than 20 mm Hg showed a higher diagnostic accuracy (91%) in the assessment of HPS than did the DLCO of less than 80% predicted (41%) and the AaPo[sub 2] of more than 15 mm Hg (71%). • Conclusions: The AaPo[sub 2] proved to be a more reliable index than Pao[sub 2] and DLCO for the determination of changes in arterial oxygenation in HPS. The DLCO does not seem to be a good marker for HPS screening. Intrapulmonary vascular dilatations were frequent, even in patients who did not fulfill the criteria for HPS.


Related Articles

  • Evolution of living donor liver transplantation over 10 years: Experience of a single center. Eguchi, Susumu; Takatsuki, Mitsuhisa; Hidaka, Masaaki; Tajima, Yoshitsugu; Kanematsu, Takashi // Surgery Today;Sep2008, Vol. 38 Issue 9, p795 

    Purpose: To evaluate the changes in living donor liver transplantations (LDLTs) over the last 10 years, we analyzed our experience of performing LDLT in a single center. Methods: We performed 73 LDLTs over the 10 years between 1997 and 2007 in Nagasaki University Hospital, Japan. Results:...

  • Should the Functional Residual Capacity be Ignored? CHANDRA SELVI, E.; KUPPU RAO, K. V. // Journal of Clinical & Diagnostic Research;Jan2013, Vol. 7 Issue 1, p43 

    Aim and Objectives: The functional residual capacity was given the least importance than the other lung volume parameters. Studies have revealed the restrictive pattern of lung disease in patients with liver cirrhosis. We aimed to analyze the importance of the functional residual capacity and...

  • Factors Prognostic of Survival in Patients Awaiting Liver Transplantation for End-Stage Liver Disease. Haldun Selcuk; Irfan Uruc; Mehtap Temel; Serkan Ocal; Bulent Huddam; Murat Korkmaz; Hakan Unal; Nurten Savas; Gurden Gur; Ugur Yilmaz; Mehmet Haberal // Digestive Diseases & Sciences;Nov2007, Vol. 52 Issue 11, p3217 

    Abstract  In this study, we investigated possible independent predictive factors for survival, other than MELD score, in patients with cirrhosis. We reviewed the serum sodium, cholesterol, albumin, and platelet levels of 99 patients with cirrhosis and investigated the possible...

  • Anesthetic considerations in parturients with liver transplant. Agarwal, Anil; Jha, Amit; Baidya, Dalim Kumar; Trikha, Anjan // Journal of Obstetric Anaesthesia & Critical Care;Jan-Jun2014, Vol. 4 Issue 1, p4 

    Advances in the surgical technique, safer anesthetic agents, improved hemodynamic monitoring, better pre-operative optimization of cirrhotic patients and postoperative critical care facilities have led to drastic improvement in the outcomes following orthotopic liver transplantation (OLT)....

  • Cardiovascular Changes in Cirrhosis: Pathogenesis and Clinical Implications. Al-hamoudi, Waleed K. // Saudi Journal of Gastroenterology;Jul2010, Vol. 16 Issue 3, p145 

    Liver cirrhosis is associated with a wide range of cardiovascular abnormalities including hyperdynamic circulation, cirrhotic cardiomyopathy, and pulmonary vascular abnormalities. The pathogenic mechanisms of these cardiovascular changes are multifactorial and include neurohumoral and vascular...

  • Liver transplantation for hepatocellular carcinoma: the Hong Kong experience. Ng, Kelvin; Lo, Chung; Chan, See; Chok, Kenneth; Cheung, Tan-To; Fan, Sheung // Journal of Hepato -- Biliary -- Pancreatic Sciences;Sep2010, Vol. 17 Issue 5, p548 

    Orthotopic liver transplantation (OLT) is the best treatment option for selected patients with hepatocellular carcinoma (HCC) with the background of cirrhosis since this treatment modality can cure both diseases at once. Over the years, the applicability of OLT for HCC has evolved. In Asia,...

  • Liver transplantation for hepatocellular carcinoma: the Baylor experience. Onaca, Nicholas; Klintmalm, Goran // Journal of Hepato -- Biliary -- Pancreatic Sciences;Sep2010, Vol. 17 Issue 5, p559 

    Background: Liver transplantation (LTX) is indicated in selected patients with hepatocellular carcinoma (HCC) and cirrhosis. Methods: We compared the outcome of LTX for patients with and without HCC in 5-year time periods between 1987 and 2007 to reflect the implementation of the Milan tumor...

  • Clinical Course and Survival after Liver Transplantation for Hepatitis B Virus Infection Complicated by Hepatocellular Carcinoma. Wong, P. Y. N.; McPeake, J. R.; Portmann, B.; Path, F. R. C.; Tan, K.-C.; Naoumov, N. V.; Williams, Roger // American Journal of Gastroenterology;Jan1995, Vol. 90 Issue 1, p29 

    Objectives and Methods: The outcome after liver transplantation for HBsAg-positive liver disease complicated by hepatocellular carcinoma is not clearly defined, and in the present study we analyzed the clinical course in 39 patients transplanted for hepatitis B virus (HBV)-related liver disease...

  • Survival and Prognostic Factors of Cirrhotic Patients with Ascites: A Study of 134 Outpatients. Salerno, Francesco; Borroni, Gianmario; Moser, Pamela; Badalamenti, Salvatore; Cassarà, Laura; Maggi, Alessandra; Fusini, Mirella; Cesana, Bruno // American Journal of Gastroenterology;Apr1993, Vol. 88 Issue 4, p514 

    Ascites is a complication of chronic liver disease that is associated with decreased survival. The purpose of the present study was to identify some prognostic factors easily obtainable by the clinician in a large group of cirrhotic patients with ascites, possibly useful for first screening of...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics