title: [Prevalence and risk factors of significant intrapulmonary shunt in cirrhotic patients awaiting liver transplantation].
abstract: OBJECTIVE
  Hepatopulmonary syndrome is a condition of severe hypoxia with intrapulmonary shunt (IPS) in the setting of hepatic dysfunction. Liver transplantation has been suggested as a definite treatment for hepatopulmonary syndrome with reversal of IPS in some patients. Inconsistency of response and inability to predict reversibility, however, are significant problems. We performed this study to evaluate the prevalence of significant IPS in pretransplantation cirrhotic patients and to find any risk factors of IPS.
  
  
  METHODS
  Fifty-seven patients (M:F = 38:19, median age 49 years (range 18-71)) with liver cirrhosis awaiting liver transplantation were serially included. Their IPS status was evaluated using contrast- enhanced echocardiography. Significant shunt was defined as a shunt of grade >or= 2.
  
  
  RESULTS
  Significant IPS was detected in 30 (52.6%) among 57 patients. Significant shunt was found in 24 (63.2%) of 38 Child-Pugh class C patients and in 6 (31.6%) of 19 Child-Pugh class A or B patients (p < 0.05). No significant difference in prevalence of significant shunt was seen according to age, sex, presence or absence of hepatocellular carcinoma, ascites, hepatic encephalopathy, and gastroesophageal varix.
  
  
  CONCLUSIONS
  Significant intrapulmonary shunt is a common finding in cirrhotic patients awaiting liver transplantation. Child-Pugh class C is the risk factor associated with high prevalence of significant shunt.
authors.affiliation: Division of Gastroenterology and Gastrointestinal Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Ji Min
authors.initials: JM
authors.lastname: Lee
authors.forename: Moon Seok
authors.initials: MS
authors.lastname: Choi
authors.forename: Sang Chol
authors.initials: SC
authors.lastname: Lee
authors.forename: Seung Woo
authors.initials: SW
authors.lastname: Park
authors.forename: Mun Hee
authors.initials: MH
authors.lastname: Bae
authors.forename: Joon Hyeok
authors.initials: JH
authors.lastname: Lee
authors.forename: Kwang Cheol
authors.initials: KC
authors.lastname: Koh
authors.forename: Seung Woon
authors.initials: SW
authors.lastname: Paik
authors.forename: Poong Lyul
authors.initials: PL
authors.lastname: Rhee
authors.forename: Jae Jun
authors.initials: JJ
authors.lastname: Kim
authors.forename: Jong Chul
authors.initials: JC
authors.lastname: Rhee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004452:Echocardiography; D005260:Female; D020065:Hepatopulmonary Syndrome / Q000209:etiology; D006801:Humans; D008103:Liver Cirrhosis / Q000503:physiopathology* / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011652:Pulmonary Circulation; D012307:Risk Factors