Health Dictionary
Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.
Hepatopulmonary syndrome surgery
Introduction
Overview
Overview
Surgery is the mainstay of treatment for hepatopulmonary syndrome. Orthotopic liver transplantation is the only available treatment for patients with hepatopulmonary syndrome.
Indications
Indications
- There are a number of indications for liver transplantation in cirrhosis divided to relative and absolute indications.
- Among them, severe cardiac and/or pulmonary diseases and severe pulmonary hypertension (mPAP >45 mm Hg) is an absolute indication.
- Plenty of patients who develop HPS are already candied for liver transplantation.
Surgery
Surgery
- Surgery is the mainstay of treatment for hepatopulmonary syndrome.
- Orthotopic liver transplantation is the only available treatment for patients with hepatopulmonary syndrome.
Complications
Complications
- Severe post-transplant hypoxemia and subsequent prolonged mechanical ventilation
- Post-operative infections
- Anastomotic bile duct leaks due to delayed wound healing because of hypoxemia
- Post-operative portal vein and hepatic artery thrombosis due to polycythemia induced by chronic hypoxemia
- Post-transplant HPS recurrence because of graft dysfunction
- Progressive pulmonary hypertension
References
References
- ↑ Swanson KL, Wiesner RH, Krowka MJ (2005) Natural history of hepatopulmonary syndrome: Impact of liver transplantation. Hepatology 41 (5):1122-9. DOI:10.1002/hep.20658 PMID: 15828054
- ↑ Nayyar D, Man HS, Granton J, Gupta S (2014) Defining and characterizing severe hypoxemia after liver transplantation in hepatopulmonary syndrome. Liver Transpl 20 (2):182-90. DOI:10.1002/lt.23776 PMID: 24142412
- ↑ Nayyar D, Man HS, Granton J, Lilly LB, Gupta S (2015) Proposed management algorithm for severe hypoxemia after liver transplantation in the hepatopulmonary syndrome. Am J Transplant 15 (4):903-13. DOI:10.1111/ajt.13177 PMID: 25649047
- ↑ Park TJ, Ahn KS, Kim YH, Kim H, Park UJ, Kim HT et al. (2014) Improved severe hepatopulmonary syndrome after liver transplantation in an adolescent with end-stage liver disease secondary to biliary atresia. Clin Mol Hepatol 20 (1):76-80. DOI:10.3350/cmh.2014.20.1.76 PMID: 24757662
- ↑ Egawa H, Kasahara M, Inomata Y, Uemoto S, Asonuma K, Fujita S et al. (1999) Long-term outcome of living related liver transplantation for patients with intrapulmonary shunting and strategy for complications. Transplantation 67 (5):712-7. PMID: 10096527
- ↑ Rodríguez-Roisin R, Krowka MJ (2008) Hepatopulmonary syndrome–a liver-induced lung vascular disorder. N Engl J Med 358 (22):2378-87. DOI:10.1056/NEJMra0707185 PMID: 18509123
- ↑ Fallon MB, Abrams GA (2000) Pulmonary dysfunction in chronic liver disease. Hepatology 32 (4 Pt 1):859-65. DOI:10.1053/jhep.2000.7519 PMID: 11003635
- ↑ Krowka MJ, Mandell MS, Ramsay MA, Kawut SM, Fallon MB, Manzarbeitia C et al. (2004) Hepatopulmonary syndrome and portopulmonary hypertension: a report of the multicenter liver transplant database. Liver Transpl 10 (2):174-82. DOI:10.1002/lt.20016 PMID: 14762853
- ↑ Kennedy TC, Knudson RJ (1977) Exercise-aggravated hypoxemia and orthodeoxia in cirrhosis. Chest 72 (3):305-9. DOI:10.1378/chest.72.3.305 PMID: 891282
- ↑ Krowka MJ, Fallon MB, Kawut SM, Fuhrmann V, Heimbach JK, Ramsay MA et al. (2016) International Liver Transplant Society Practice Guidelines: Diagnosis and Management of Hepatopulmonary Syndrome and Portopulmonary Hypertension. Transplantation 100 (7):1440-52. DOI:10.1097/TP.0000000000001229 PMID: 27326810
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Soroush Seifirad, M.D.[2]