Effect of transjugular intrahepatic portosystemic shunt on pulmonary gas exchange in patients with portal hypertension and hepatopulmonary syndrome.
OBJECTIVE
To assess the impact of transjugular intrahepatic portosystemic shunt (TIPS) on pulmonary gas exchange and to evaluate the use of TIPS for the treatment of hepatopulmonary syndrome ( HPS ).


METHODS
Seven patients, three of them with advanced HPS, in whom detailed pulmonary function tests were performed before and after TIPS placement at the University of Alabama Hospital and at the Hospital Clinic, Barcelona, were considered.


RESULTS
TIPS patency was confirmed by hemodynamic evaluation. No changes in arterial blood gases were observed in the overall subset of patients. Transient arterial oxygenation improvement was observed in only one HPS patient, early after TIPS, but this was not sustained 4 mo later.


CONCLUSIONS
TIPS neither improved nor worsened pulmonary gas exchange in patients with portal hypertension. This data does not support the use of TIPS as a specific treatment for HPS. However, it does reinforce the view that TIPS can be safely performed for the treatment of other complications of portal hypertension in patients with HPS.
Martinez-Palli
Graciela
G
Servei d'Anestesiologia i Reanimacio Hospital Clinic, Institut d'Investigacions Biomediques august Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.
Drake
Britt B
BB
Garcia-Pagan
Joan-Carles
JC
Barbera
Joan-Albert
JA
Arguedas
Miguel R
MR
Rodriguez-Roisin
Robert
R
Bosch
Jaume
J
Fallon
Michael B
MB
D000328:Adult; D000368:Aged; D005260:Female; D006439:Hemodynamics; D020065:Hepatopulmonary Syndrome / Q000628:therapy*; D006801:Humans; D006975:Hypertension, Portal / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D019168:Portasystemic Shunt, Transjugular Intrahepatic; D011659:Pulmonary Gas Exchange / Q000502:physiology*