30 Excellent Outcome of Living Donor Liver Transplantation in Patients With Hepatopulmonary Syndrome-a Single Center Experience

Saigal, Sanjiv; Saraf, N; Ragesh, B; Mohanka, Ravi; Kakodkar, Rahul; Rastogi, Archana; Goja, Sanjay; Balachandran, Parvathi; Soin, AS

doi:10.1016/s0973-6883(11)60167-9

Cited by 3 publications

(4 citation statements)

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“…Some reports showed worse survival in patients who have severe HPS [9,10]. However, some other studies showed that there were no significant differences in the survival between any HPS or non-HPS patients [11,13]. The previous Japanese multicenter study showed significant inferior effects of HPS on treatment outcome [2,3].…”

Section: Discussionmentioning

confidence: 98%

“…The causes of death were intracranial bleeding on POD 30, graft failure secondary to thrombotic microangiopathy on POD 33, and pulmonary fibrosis on POD 42. The only known effective therapy for HPS is LT [8][9][10][11], with an improvement in the oxygenation at 1 year [12][13][14]. Some reports showed worse survival in patients who have severe HPS [9,10].…”

Section: Discussionmentioning

confidence: 99%

“…Most of our data were from cases of LDLT. LDLT may be more suitable than deceased donor LT (DDLT) because of the advantages of the immediate availability of graft and the opportunity to stabilize the patients before LT . The assessment of HPS is important to improve the outcome of LT.…”

Section: Discussionmentioning

confidence: 99%

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Current status of hepatopulmonary syndrome in liver transplantation in Japan: a Japanese multicenter analysis

Kotera

Egawa

Ogata

et al. 2019

J Hepato Biliary Pancreat

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Background Hepatopulmonary syndrome (HPS) negatively affects the outcomes of deceased donor liver transplantation (LT). Methods We retrospectively reviewed the clinical records of patients with HPS who underwent LT and studied the impact of risk factors on clinical outcomes to determine strategies to overcome complications. Patients with symptoms of hypo‐oxygenemia and a shunt ratio >15% on 99mTc‐MAA lung perfusion scintigraphy were defined as having HPS. Results Forty‐eight patients in 10 centers were enrolled. Diseases included biliary atresia, liver cirrhosis, non‐alcoholic steatohepatitis, congenital hepatic fibrosis, and others. The length of ICU stay was 2–170 days. The respirator was used for 41.6% of patients on post‐operative day (POD) 3 and 20.8% on POD 14. The patient survival rate was 87% at 1 year and 82% at 5 years. The causes of hospital mortality were sepsis, thrombotic microangiopathy, intracranial bleeding, pulmonary fibrosis, and transplant rejection. An amount of shunt ratio prior to LT was a significant risk factor for hospital mortality. Hypoxia from POD 3 to POD 14 was a risk factor for biliary stenosis. The shunt ratio of all surviving patients significantly improved. Conclusion Although LT is feasible for patients with HPS, early transplantation and avoiding hypo‐oxygenemia immediately after transplantation are important.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

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Current status of hepatopulmonary syndrome in liver transplantation in Japan: a Japanese multicenter analysis

Kotera

Egawa

Ogata

et al. 2019

J Hepato Biliary Pancreat

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“…The prevalence of HPS varies from 4–47% due to different cut-offs in defining arterial hypoxemia in primary studies, and its mortality rate is about 41% 3 4 . Although progress has been made in delineating the mechanisms underlying the imbalance of vasoactive substances, pulmonary vascular alterations and angiogenesis in HPS, to date, there is still lack of effective therapeutic approaches apart from liver transplantation (LT) 5 6 7 .…”

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confidence: 99%

Inhibition of autophagy ameliorates pulmonary microvascular dilation and PMVECs excessive proliferation in rat experimental hepatopulmonary syndrome

Chen

et al. 2016

Sci Rep

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Hepatopulmonary syndrome (HPS) is a defective liver-induced pulmonary vascular disorder with massive pulmonary microvascular dilation and excessive proliferation of pulmonary microvascular endothelial cells (PMVECs). Growing evidence suggests that autophagy is involved in pulmonary diseases, protectively or detrimentally. Thus, it is interesting and important to explore whether autophagy might be involved in and critical in HPS. In the present study, we report that autophagy was activated in common bile duct ligation (CBDL) rats and cultured pulmonary PMVECs induced by CBDL rat serum, two accepted in vivo and in vitro experimental models of HPS. Furthermore, pharmacological inhibition of autophagy with 3-methyladenine (3-MA) significantly alleviated pathological alterations and typical symptom of HPS in CBDL rats in vivo, and consistently 3-MA significantly attenuated the CBDL rat serum-induced excessive proliferation of PMVECs in vitro. All these changes mediated by 3-MA might explain the observed prominent improvement of pulmonary appearance, edema, microvascular dilatation and arterial oxygenation in vivo. Collectively, these results suggest that autophagy activation may play a critical role in the pathogenesis of HPS, and autophagy inhibition may have a therapeutic potential for this disease.

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Overview of Complications in Cirrhosis

Premkumar¹,

Anand²

2022

Journal of Clinical and Experimental Hepatology

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30 Excellent Outcome of Living Donor Liver Transplantation in Patients With Hepatopulmonary Syndrome-a Single Center Experience

Abstract: refractory infection with a high mortality rate. We present this case as a difficult clinical problem and a unique pediatric experience.

Cited by 3 publications

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Current status of hepatopulmonary syndrome in liver transplantation in Japan: a Japanese multicenter analysis

Current status of hepatopulmonary syndrome in liver transplantation in Japan: a Japanese multicenter analysis

Inhibition of autophagy ameliorates pulmonary microvascular dilation and PMVECs excessive proliferation in rat experimental hepatopulmonary syndrome

Overview of Complications in Cirrhosis

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