title: Late recurrence and rapid evolution of severe hepatopulmonary syndrome after liver transplantation.
abstract: Recurrence of hepatopulmonary syndrome (HPS) after orthotopic liver transplantation (OLT) in an adult has never been reported. We describe a 23-year-old woman who initially underwent OLT because of debilitating and severe HPS associated with nonalcoholic steatohepatitis (NASH). Although the clinical resolution of HPS was well documented day 117 post-OLT, the reappearance of NASH was documented by liver biopsy. Severe hypoxemia because of recurrent HPS rapidly evolved beginning approximately day 700 post-OLT. Retransplantation was attempted, but the patient died post-OLT of sepsis and/or multiorgan failure.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: M J
authors.initials: MJ
authors.lastname: Krowka
authors.forename: G A
authors.initials: GA
authors.lastname: Wiseman
authors.forename: J L
authors.initials: JL
authors.lastname: Steers
authors.forename: R H
authors.initials: RH
authors.lastname: Wiesner
mesh_terms: D000208:Acute Disease; D000328:Adult; D001706:Biopsy; D017809:Fatal Outcome; D005234:Fatty Liver / Q000150:complications / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D020065:Hepatopulmonary Syndrome / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D012008:Recurrence; D012086:Reoperation