Hepatopulmonary syndrome in candidates for liver transplantation

• Published in: Journal of hepatology 2001-05, Vol.34 (5), p.651-657
• Main Authors: Martı́nez, G.P, Barberà, J.A, Visa, J, Rimola, A, Paré, J.C, Roca, J, Navasa, M, Rodés, J, Rodriguez-Roisin, R
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Diffusing capacity; Digestive system; Dyspnea - complications; Female; Fingers - abnormalities; Hepatopulmonary Syndrome - complications; Hepatopulmonary Syndrome - epidemiology; Hepatopulmonary Syndrome - physiopathology; Hepatopulmonary Syndrome - surgery; Humans; Incidence; Investigative techniques, diagnostic techniques (general aspects); Liver Transplantation; Lung–liver interaction; Male; Medical sciences; Middle Aged; Multiple inert gas elimination technique; Organ transplantation; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Prospective Studies; Pulmonary Diffusing Capacity; Pulmonary gas exchange; Ventilation-Perfusion Ratio
• ISSN: 0168-8278; 1600-0641
• DOI: 10.1016/S0168-8278(00)00108-2

Background : Hepatopulmonary syndrome (HPS) has been defined as a clinical triad, including chronic liver disease, gas exchange defects (increased alveolar–arterial PO 2 difference irrespective of the presence of arterial hypoxemia), and widespread intrapulmonary vascular dilatations. We determined the incidence and the clinical and pulmonary functional characteristics of HPS in candidates for orthotopic liver transplantation (OLT) and tested their predicted accuracy. Methods : We studied 80 patients with cirrhosis prospectively, and carried out contrast-enhanced (CE) echocardiography and lung function tests, including ventilation–perfusion (V̇ A/Q̇) distributions. Results : Fourteen patients had HPS (incidence, 17.5%). Patients with HPS (49±12 (±SD) years) had more cutaneous spiders, finger clubbing and dyspnea ( P