The utility of the macro-aggregated albumin lung perfusion scan in the diagnosis and prognosis of hepatopulmonary syndrome in cirrhotic patients candidates for liver transplantation

Grilo, Israel; Pascasio, J.M.; Tirado, Juan Luis; López-Pardo, Francisco-Jesús; Ruiz, Francisco Órtega; Sousa, J.M.; Rodríguez-Puras, María J.; Ferrer, María Teresa Martínez; Gómez‐Bravo, Miguel Ángel; Reina, A

doi:10.17235/reed.2017.4219/2016

Cited by 5 publications

(3 citation statements)

References 24 publications

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“…This is in agreement with two previous studies which have shown a high prevalence of concomitant respiratory disease in 38.1% and 46.6% of HPS patients. 9,12 COPD was one of the most common co-existing respiratory disease.…”

Section: Concomitant Respiratory Disease (Yes Vs No)mentioning

confidence: 99%

“…9,10 Until now, less attention has been given to the presence of chronic intrinsic respiratory conditions which may coexist with HPS and may affect both preoperative and postoperative hypoxemia and outcome. 2,11,12 This study aimed to determine the outcome after LT in a cohort of patients with HPS with versus without concomitant respiratory disease.…”

Section: Introductionmentioning

confidence: 99%

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Outcomes of liver transplantation for hepatopulmonary syndrome in patients with concomitant respiratory disease

Koc,

Aslan,

Kramer

et al. 2023

Clinical Transplantation

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Background & aimsConcomitant respiratory disease is a common finding in patients with hepatopulmonary syndrome (HPS). Among patients who underwent liver transplantation (LT) for HPS, we compared characteristics and outcome of patients with versus without concomitant respiratory disease.MethodsThis single center retrospective observational study included patients with HPS who underwent LT between 1999 and 2020.ResultsDuring the study period, 32 patients with HPS received a LT; nine (28%) with concomitant respiratory disease of whom one required a combined lung‐liver transplantation. Patients with concomitant respiratory disease had higher PaCO2 (38 vs. 33 mm Hg, p = .031). The 30‐day postoperative mortality was comparable, but the estimated cumulative probability of resolution of oxygen therapy after LT in HPS patients with versus those without concomitant respiratory disease was lower: 63% versus 91% at 12 months and 63% versus 100% at 18 months (HR 95% CI .140–.995, p = .040). In addition to the presence of concomitant respiratory disease (p = .040), history of smoking (p = .012), and high baseline 99mTcMAA shunt fraction (≥20%) (p = .050) were significantly associated with persistent need of oxygen therapy. The 5‐year estimated cumulative probability of mortality in patients with concomitant respiratory disease was worse: 50% versus 23% (HR 95% CI .416–6.867, p = .463).ConclusionsThe presence of a concomitant respiratory disease did not increase the short‐term postoperative mortality after LT in patients with HPS. However, it resulted in a longer need for oxygen therapy.

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Section: Concomitant Respiratory Disease (Yes Vs No)mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Outcomes of liver transplantation for hepatopulmonary syndrome in patients with concomitant respiratory disease

Koc,

Aslan,

Kramer

et al. 2023

Clinical Transplantation

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“…The overall sensitivity of 99mTc-MAA in the diagnosis of HPS is 18.9% in all HPS cases, which is relatively low, but it is 66.7% in severe to very severe cases. Consequently, it can be used in patients with pulmonary disease and severe to very severe HPS (28).…”

Section: Progress In Technetium 99m-labeled Macroaggregated Albumin (Tc-mma) Dynamic Lung Perfusion Scan For the Diagnosis Of Hpsmentioning

confidence: 99%

Advances in Diagnostic Imaging of Hepatopulmonary Syndrome

Luo

2022

Front. Med.

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Hepatopulmonary syndrome (HPS) is a serious pulmonary complication of progressive liver disease that leads to a poor clinical prognosis. Patients with HPS may develop acute respiratory failure, which requires intensive care and therapy. At present, the only effective treatment is liver transplantation; therefore, early diagnosis and timely treatment are of considerable significance. The three main features of HPS are liver disease, oxygenation disorder, and intrapulmonary vascular dilatation (IPVD). Diagnosing HPS is challenging due to the difficulty in detecting the presence or absence of IPVD. As such, imaging examination is very important for detecting IPVD. This paper reviews the imaging methods for diagnosing HPS such as ultrasound, dynamic pulmonary perfusion imaging, pulmonary angiography, and computed tomography.

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Aktualisierte S2k-Leitlinie der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) „Komplikationen der Leberzirrhose“

et al. 2019

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ZusammenfassungDie Leitlinie Komplikationen der Leberzirrhose der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) ersetzt die Leitlinie aus dem Jahr 2011. Sie basiert auf den Empfehlungen der Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF) für eine evidenzbasierte Konsensus-Leitlinie der Entwicklungsstufe S2k und wurde interdisziplinär unter Beteiligung aller relevanten Fachgesellschaften und der Patientenvertretung erstellt. Neben den in der Vorgängerversion behandelten Kapiteln Aszites, spontan bakterielle Peritonitis, hepatorenales Syndrom, hepatischer Hydrothorax und hepatopulmonales Syndrom wurden die Kapitel Diagnostik und Therapie der Hepatischen Enzephalopathie neu aufgenommen.

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The utility of the macro-aggregated albumin lung perfusion scan in the diagnosis and prognosis of hepatopulmonary syndrome in cirrhotic patients candidates for liver transplantation

Abstract: The 99mTc-MAA is a low sensitivity test for the diagnosis of HPS that can be useful in patients who have concomitant lung disease and in severe to very severe cases of HPS. It was not related to mortality, and brain uptake normalized after LT.

Cited by 5 publications

References 24 publications

Outcomes of liver transplantation for hepatopulmonary syndrome in patients with concomitant respiratory disease

Outcomes of liver transplantation for hepatopulmonary syndrome in patients with concomitant respiratory disease

Advances in Diagnostic Imaging of Hepatopulmonary Syndrome

Aktualisierte S2k-Leitlinie der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) „Komplikationen der Leberzirrhose“

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