[Hepatopulmonary syndrome in liver transplantation candidates].
BACKGROUND
Hepatopulmonary syndrome is an important clinical problem associated with chronic liver disease. Liver transplantation can result in complete resolution of the arterial hypoxemia associated with this syndrome, even in its most severe presentation.


OBJECTIVE
To determine the prevalence of hepatopulmonary syndrome in adult liver transplant candidates.


METHODS
Fifty-four consecutives adult patients (> or = 18 years) with severe liver disease waiting for liver transplant were screened for arterial hypoxemia (PaO2 < 70 mm Hg) while they were seated, at rest, and breathing room air. Patients with arterial hypoxemia underwent contrast-enhanced two-dimensional echocardiography and pulmonary function testing. Hypoxemia (PaO2 < 70 mm Hg) was present in 7 of 54 patients (12.9%), although only 1 of them complained of dyspnea. The Child's classification of the patients were: A = 1, B = 4, and C = 1. All seven hypoxemic patients had positive contrast-enhanced two-dimensional echocardiography, consistent with hepatopulmonary syndrome.


CONCLUSIONS
The prevalence of hepatopulmonary syndrome in adult liver transplant candidates is elevated. The screening for hepatopulmonary syndrome should be part of the routine evaluation of liver transplant candidates even in the absence of pulmonary symptoms.
Parolin
Mônica Beatriz
MB
Serviço de Transplante Hepático, Laboratório de Provas de Funçào Pumonar, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR. mbparolin@hotmail.com
Coelho
Júlio Cézar Uili
JC
Puccinelli
Vanessa
V
Schulz
Gustavo J
GJ
de Souza
Admar Moraes
AM
de Barros
João Adriano
JA
D000328:Adult; D000368:Aged; D001938:Brazil / Q000453:epidemiology; D005260:Female; D020065:Hepatopulmonary Syndrome / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D008107:Liver Diseases / Q000150:complications / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D015995:Prevalence