Abstract :
Hypoxemia is found in 10-40% of cirrhotic patients. Hepatopulmonary syndrome (HPS) is a unique condition
presenting in patients with liver diseases and/or portal hypertension. A 51-year-old man who was a known
case of alcohol and chronic hepatitis C-related decompensate cirrhosis was referred to our hospital for cadaveric
liver transplantation. The patient developed severe persistent hypoxemia with increased alveolar-arterial oxygen
tension gradient [P(A-a)DO
2] during the postoperative period. Pulmonary embolism was excluded by pulmonary2 gradually decreased and arterial blood gas returned to normal within 6 months following
artery catheterization. Contrast echocardiography demonstrated an extracardiac (or intrapulmonary) shunt and the
diagnosis of HPS was made. He required intubation, mechanical ventilation and a prolonged stay in the intensive
care unit. P(A-a)DO
liver transplantation. Although the presence of HPS in cirrhotic patients is associated with high mortality, liver
transplantation is the only established treatment for HPS. Screening for HPS in liver transplant candidates is
recommended for the improvement of pre- and post-transplantation survival. |
file/Thai-Journal-of-gastroenterology-vol-9-no-3-2028377.pdf