Inhaled iloprost for hepatopulmonary syndrome: improvement of hypoxemia.
Hepatopulmonary syndrome is characterized by advanced liver disease, hypoxemia, and intrapulmonary shunting. The only reported curative option is orthotopic liver transplantation. We describe here a beneficial effect of inhaled prostacyclin including a decrease in respiratory symptoms and improved oxygenation in this clinical situation, with no approved pharmacological long-term therapy. The prostanoid iloprost, approved for pulmonary and portopulmonary hypertension, caused an increase in oxygenation, relief of dyspnea, and increased exercise tolerance in a patient suffering from liver-cirrhosis-associated hepatopulmonary syndrome. After liver transplantation, restitution of hepatopulmonary syndrome did not occur immediately. Inhaling iloprost resulted in improved physical condition and better clinical rehabilitation potential until hypoxemia finally resolved 3 months after transplantation. Therefore, iloprost could improve quality of life in patients with hepatopulmonary syndrome waiting for liver transplantation and post surgery until the resolution of the hypoxemia.
Krug
Sabine
S
Department of Pulmonary Medicine, University of Leipzig, Leipzig, Germany. sabine.krug@medizin.uni-leipzig.de
Seyfarth
Hans-Juergen
HJ
Hagendorff
Andreas
A
Wirtz
Hubert
H
D000280:Administration, Inhalation; D005260:Female; D020065:Hepatopulmonary Syndrome / Q000188:drug therapy* / Q000601:surgery; D006801:Humans; D000860:Hypoxia / Q000188:drug therapy*; D016285:Iloprost / Q000008:administration & dosage*; D016031:Liver Transplantation; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D010313:Partial Pressure; D011182:Postoperative Care / Q000379:methods; D014665:Vasodilator Agents / Q000008:administration & dosage*
D014665:Vasodilator Agents; D016285:Iloprost; D010100:Oxygen