Impact of mild and moderate intrapulmonary shunting in children with end-stage liver disease undergoing liver transplantation.
OBJECTIVE
The aim of this study was to evaluate the impact of mild and moderate intrapulmonary shunting (IPS) in children with end-stage liver disease (ESLD) undergoing liver transplantation.


METHODS
A total of 73 patients (38 male, 35 female; mean age 31.5 +/- 35.2 months, range 6-180 months) with ESLD and subsequent liver transplantation were enrolled. Based on contrast echocardiography, patients without IPS were assigned to group 1 (n = 57), and patients with mild or moderate IPS were assigned to group 2 (n = 17). The preoperative age, body weight, O(2) saturation, length of hospital stay, duration of mechanical ventilation, postoperative complications, and 1-year survival rate were compared between groups.


RESULTS
The overall incidence of IPS and 1-year survival rate were 23.3% (17/73) and 96% (70/73), respectively. There were significant differences between group 1 and group 2 patients regarding age at transplant (35.9 vs. 16.6 months, p = 0.002) and body weight (12.6 vs. 8.5 kg, p = 0.002). There were no other statistically significant differences between the two groups.


CONCLUSIONS
Although children with mild and moderate IPS were younger at the time of transplantation and had significantly lower body weight than those without IPS, the presence of mild and moderate IPS in children with ESLD did not affect the overall outcome of liver transplantation.
Liang
Chi-Di
CD
Liver Transplantation Program, Section of Pediatric Cardiology, Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao Sung, Kaohsiung 833, Taiwan.
Ko
Sheung-Fat
SF
Chen
Chao-Long
CL
Concejero
Allan M
AM
D000293:Adolescent; D001656:Biliary Atresia / Q000503:physiopathology / Q000601:surgery; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D005260:Female; D006505:Hepatitis / Q000503:physiopathology / Q000601:surgery; D020065:Hepatopulmonary Syndrome / Q000503:physiopathology*; D006801:Humans; D000860:Hypoxia / Q000209:etiology; D007223:Infant; D007902:Length of Stay; D008107:Liver Diseases / Q000503:physiopathology* / Q000601:surgery*; D016031:Liver Transplantation; D011652:Pulmonary Circulation / Q000502:physiology; D016896:Treatment Outcome