Severe pulmonary hypertension and amelioration of hepatopulmonary syndrome after liver transplantation.
A patient with end-stage liver disease as a result of alpha1-antitripsin deficiency presented for orthotopic liver transplantation. The liver cirrhosis was complicated by portal hypertension and hepatopulmonary syndrome resulting in varicosities and severe hypoxia (room air oxygen saturation 69%). After transplantation, the hepatopulmonary syndrome improved but, over the next 14 months, the patient developed severe pulmonary hypertension. Six years posttransplantation, his room air oxygen saturation was 95% with pulmonary artery pressures of 109 mm Hg systolic and 26 mm Hg diastolic (mean 55 mm Hg) and a pulmonary vascular resistance 688 dynes x sec x cm.
Kaspar
M D
MD
Department of Anesthesiology and Pain Management, Baylor University Medical Center, Dallas, TX 75246, USA.
Ramsay
M A
MA
Shuey
C B
CB
Levy
M F
MF
Klintmalm
G G
GG
D000328:Adult; D004108:Dilatation, Pathologic / Q000150:complications / Q000601:surgery; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications*; D000860:Hypoxia / Q000150:complications; D007676:Kidney Failure, Chronic / Q000150:complications / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D011183:Postoperative Complications; D011651:Pulmonary Artery / Q000473:pathology*; D011667:Pulmonary Veins / Q000473:pathology*