title: Liver transplantation resolves the hyperdynamic circulation in hereditary hemorrhagic telangiectasia with hepatic involvement.
abstract: OBJECTIVE
  Hepatic involvement in hereditary hemorrhagic telangiectasia is common but often asymptomatic. However, in some cases, the vascular lesions that involve the liver may lead to high-output cardiac failure and pulmonary hypertension that is predominant over hepatobiliary manifestations. Liver transplantation and treatment of these complications are described and discussed in this article.
  
  
  METHODS
  Three patients with hereditary hemorrhagic telangiectasia and hepatic involvement received transplants. They had pulmonary hypertension and chronic right-sided heart failure caused by disseminated intrahepatic telangiectasias with shunts between the hepatic artery and hepatic veins or portal vein. Left-to-right intrahepatic shunt output was estimated to range between 51% and 57.5% of cardiac output.
  
  
  RESULTS
  Hyperdynamic circulation disappeared after liver transplantation in all patients. Results of computed tomography and right-sided heart catheterization performed 6 months later were normal. Follow-up periods currently are 65, 53, and 29 months, and each patient continues to be asymptomatic.
  
  
  CONCLUSIONS
  This report suggests that liver transplantation can be considered as an alternative and successful curative treatment that may prevent the irreversible evolution of cardiopulmonary disease.
authors.affiliation: Unité de transplantation hépatique, Fédération des spécialités digestives, Hôpital Eduard Herriot, Lyon, France. boillot@cismsun.univ-lyon1.fr
authors.forename: O
authors.initials: O
authors.lastname: Boillot
authors.forename: F
authors.initials: F
authors.lastname: Bianco
authors.forename: J P
authors.initials: JP
authors.lastname: Viale
authors.forename: F
authors.initials: F
authors.lastname: Mion
authors.forename: I
authors.initials: I
authors.lastname: Mechet
authors.forename: D
authors.initials: D
authors.lastname: Gille
authors.forename: J
authors.initials: J
authors.lastname: Delaye
authors.forename: P
authors.initials: P
authors.lastname: Paliard
authors.forename: H
authors.initials: H
authors.lastname: Plauchu
mesh_terms: D000328:Adult; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000517:prevention & control; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications; D008102:Liver Circulation; D008111:Liver Function Tests; D016031:Liver Transplantation; D008875:Middle Aged; D012129:Respiratory Function Tests; D013683:Telangiectasia, Hereditary Hemorrhagic / Q000150:complications / Q000503:physiopathology* / Q000601:surgery*; D014057:Tomography, X-Ray Computed