Liver transplantation in a patient with pulmonary hypertension at high altitude.
Chronic hypoxia at high altitude stresses many of the body's homeostatic mechanisms. As a consequence, the body develops alveolar hypoxia, hypoxemia, and polycythemia, which in turn causes vasoconstriction, pulmonary hypertension, and an increased risk of atherothrombotic complications. We report a successful liver transplantation in a patient with pulmonary hypertension who lives 4500 m above sea level. Pulmonary hypertension and hypercoagulable state induced by chronic hypoxia at high altitude may increase the risk of cardiopulmonary complication and perioperative mortality. The patient was discharged in good condition with normal liver function at the 34th postoperative day. After 41 months of follow-up, the patient is alive and well with a continued normalization of hepatic function and is continuing to live at 4500 m above sea level.
Dou
Kefeng
K
Department of Hepatobiliary Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shannxi Province, China. hepato@fmmu.edu.cn
Wang
Desheng
D
Zhao
Qingchuan
Q
Song
Zhenshun
Z
Yue
Shuqiang
S
Tao
Kaishan
K
Chen
Shaoyang
S
He
Yong
Y
Ti
Zhenyu
Z
D000531:Altitude; D001777:Blood Coagulation / Q000502:physiology; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology / Q000503:physiopathology*; D000860:Hypoxia / Q000097:blood / Q000503:physiopathology; D008103:Liver Cirrhosis / Q000628:therapy*; D008111:Liver Function Tests; D016031:Liver Transplantation; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D016896:Treatment Outcome