Rapid normalization of portopulmonary hypertension after living donor liver transplantation.
Portopulmonary hypertension (PPHTN) is a relatively rare complication of end-stage liver disease, and a serious problem in the context of liver transplantation. Herein we have reported a case of decompensated liver cirrhosis with PPHTN, which rapidly resolved after adult-to-adult living donor liver transplantation (LDLT). A 54-year-old man was referred to our hospital with end-stage liver cirrhosis owing to chronic hepatitis C. Preoperative mean pulmonary artery pressure (mPAP), as assessed by right heart catheterization, was 38 mm Hg. Continuous infusion of epoprostenol decreased the mPAP to 24 mm Hg over 44 days. He underwent LDLT using a right hepatic lobe graft donated by his son. The postoperative course was uneventful, epoprostenol was weaned by postoperative day (POD) 21, and the mPAP normalized to 21 mm Hg on POD 28. The patient was discharged on POD 31 without any vasodilators. Our case revealed that liver transplantation can rapidly resolve PPTHN.
Sugimachi
K
K
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. ksugi@surg2.med.kyushu-u.ac.jp
Soejima
Y
Y
Morita
K
K
Ueda
S
S
Fukuhara
T
T
Nagata
S
S
Ikegami
T
T
Taketomi
A
A
Maehara
Y
Y
D000959:Antihypertensive Agents / Q000627:therapeutic use; D011464:Epoprostenol / Q000627:therapeutic use; D006439:Hemodynamics; D019698:Hepatitis C, Chronic / Q000601:surgery*; D006801:Humans; D006975:Hypertension, Portal / Q000188:drug therapy / Q000209:etiology*; D006976:Hypertension, Pulmonary / Q000188:drug therapy / Q000209:etiology*; D008103:Liver Cirrhosis / Q000150:complications / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
D000959:Antihypertensive Agents; D011464:Epoprostenol