Excellent outcome of living donor liver transplantation in patients with hepatopulmonary syndrome: a single centre experience

Saigal, Sanjiv; Choudhary, Narendra S.; Saraf, Neeraj; Kotecha, Hardik; Kakodkar, Rahul; Mohanka, Ravi; Rastogi, Amit; Menon, P.B.; Goja, Sanjay; Govil, Deepak; Vohra, Vijay; Soin, Arvinder S.

doi:10.1111/ctr.12126

Cited by 22 publications

(7 citation statements)

References 19 publications

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“… 90 , 91 In the same study, patients with a pretransplantation PaO 2 < 44 mmHg had significantly lower post-transplantation survival rates compared with those with a PaO 2 between 44 and 54 mmHg. 90 It may come to mind that living donor LT (LDLT) may be more suitable than deceased donor LT (DDLT) because of the advantages of immediate availability of graft and opportunity to stabilize patient before LT. 86 However, some reports have shown that complication rates are the same between LDLT and DDLT patients. 92 – 95 To improve survival after LT, patients who are on the waiting list should be screened properly, and adequate oxygen should be given.…”

Section: Treatmentmentioning

confidence: 99%

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Hepatopulmonary Syndrome and Liver Transplantation: A Recent Review of the Literature

Coşarderelioğlu

Coşar

Gürakar

et al. 2016

JCTH

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A severe and common pulmonary vascular complication of liver disease is hepatopulmonary syndrome (HPS). It is a triad of liver dysfunction and/or portal hypertension, intrapulmonary vascular dilatations, and increased alveolar-arterial oxygen gradient. Prevalence varies according to various study groups from 4%-47%. While the most common presenting symptom of HPS is dyspnea, it is usually asymptomatic, and thus all liver transplant candidates should be screened for its presence. Pulse oximetry is a useful screening method, but arterial blood gas examination is the gold standard. If there is an abnormal P (A-a)O 2 gradient, microbubble transthoracic echocardiography should be done for diagnosis. Outcome is unpredictable, and there is currently no effective medical therapy. The only effective therapy is considered to be liver transplantation. Complete resolution of HPS after liver transplantation is seen within a year in most HPS patients.

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Section: Treatmentmentioning

confidence: 99%

“… 84 , 88 However, some other studies showed that there were no significant differences in survival between any HPS and non-HPS patients. 86 , 89 Iyer et al . reported that there was no association between PaO 2 levels at diagnosis and survival rates after transplantation.…”

Section: Treatmentmentioning

confidence: 99%

Hepatopulmonary Syndrome and Liver Transplantation: A Recent Review of the Literature

Coşarderelioğlu

Coşar

Gürakar

et al. 2016

JCTH

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“…Only a few case series exist of LDLT in this setting and the largest describes 14 patients with excellent results. 10 They found that the overall time to extubation was 2 (1-32 days) and hospital stay was 20 (17-46 days). However, the length of time of normalization of arterial hypoxemia post LT is highly variable.…”

Section: Discussionmentioning

confidence: 99%

Liver Transplantation After Bone Marrow Transplantation for End Stage Liver Disease with Severe Hepatopulmonary Syndrome in Dyskeratosis Congenita: A Literature First

Mahansaria

Kumar

Bharathy

et al. 2015

Journal of Clinical and Experimental Hepatology

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Dyskeratosis congenita is a multisystem genetic disorder. Although hepatic involvement is reported in about 7% of patients with dyskeratosis congenita, it is not well characterized and often attributed to hemochromatosis from frequent blood transfusions. A few case reports describe cirrhosis and hepatic cell necrosis in affected individuals in autosomal dominant pedigrees. Bone marrow failure and malignancies are the principal causes of death in dyskeratosis congenita. We describe the first case of living donor liver transplantation, in dyskeratosis congenita for decompensated cirrhosis with portal hypertension. The patient also had associated severe hepatopulmonary syndrome, interstitial lung disease, bilateral hip replacement for avascular necrosis of the head of femur, and a past history of bone marrow transplantation for bone marrow failure.

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“…LT is the only cure for HPS, and the outcome of patients after LT is generally good . In one report, Saigal et al . reported 100% survival in patients with HPS after LT.…”

Section: Introductionmentioning

confidence: 99%

Successful venoarterial extracorporeal membrane oxygenation for prolonged hepatopulmonary syndrome following pediatric liver transplantation: A case report and review of the literature

Khan

Schroeder

Fitzpatrick

et al. 2017

Pediatric Transplantation

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HPS is a major complicating feature of end-stage liver disease. Diagnosis is clinical, and LT is the only definitive treatment. While the general impression is that HPS improves quickly after transplantation, it may not always be the case. We describe the smallest reported child with HPS prior to LT and requiring prolonged venoarterial extracorporeal membrane oxygenation after LT; especially as it is a rare occurrence, physician managing such cases should be aware of the circumstances under which HPS may require specific treatment.

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Excellent outcome of living donor liver transplantation in patients with hepatopulmonary syndrome: a single centre experience

Abstract: We report one of the largest series of LDLT in HPS which has shown excellent results.

Cited by 22 publications

References 19 publications

Hepatopulmonary Syndrome and Liver Transplantation: A Recent Review of the Literature

Hepatopulmonary Syndrome and Liver Transplantation: A Recent Review of the Literature

Liver Transplantation After Bone Marrow Transplantation for End Stage Liver Disease with Severe Hepatopulmonary Syndrome in Dyskeratosis Congenita: A Literature First

Successful venoarterial extracorporeal membrane oxygenation for prolonged hepatopulmonary syndrome following pediatric liver transplantation: A case report and review of the literature

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