[Severe refractory pulmonary hypertension after liver transplantation for hepatitis C liver cirrhosis].
BACKGROUND
We report the case of a 43-year-old male with liver cirrhosis based on a chronically active hepatitis C.


METHODS
Before liver transplantation right-ventricular pressure values of 36 mmHg (+ central venous pressure) were measured whereas, after transplantation, he developed severe pulmonary hypertension with pressure values up to 90 mmHg. These elevated pressure values correlated inversely with graft function. Given the diagnosis of portopulmonary hypertension, we initiated treatment with intravenous epoprostenol and inhalative iloprost but both treatments were not tolerated because of systemic side effects. A combined heart-lung transplantation was considered but the patient died from insufficient cardiac function.


CONCLUSIONS
The case report discusses the present diagnostic and therapeutic state of the art in portopulmonary hypertension and reveals basic problems of the present screening strategy.
Dietrich
C G
CG
Medizinische Klinik III, Klinikum der RWTH Aachen.
Gartung
C
C
Siewert
E
E
Lammert
F
F
Matern
S
S
Geier
A
A
D000328:Adult; D000959:Antihypertensive Agents / Q000008:administration & dosage; D004338:Drug Combinations; D011464:Epoprostenol / Q000008:administration & dosage; D017809:Fatal Outcome; D006526:Hepatitis C / Q000150:complications / Q000601:surgery*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis* / Q000188:drug therapy* / Q000209:etiology; D016285:Iloprost / Q000008:administration & dosage; D008103:Liver Cirrhosis / Q000209:etiology / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D017211:Treatment Failure; D014665:Vasodilator Agents / Q000008:administration & dosage
D000959:Antihypertensive Agents; D004338:Drug Combinations; D014665:Vasodilator Agents; D011464:Epoprostenol; D016285:Iloprost