Pulmonary evaluation in pediatric liver transplant candidates.
OBJECTIVE
Liver transplantation (LT) maybe complicated by pulmonary problems. This study aimed to evaluate pulmonary function and gas exchange abnormalities in pediatric patients listing for LT.


METHODS
In total, 79 pediatric patients with advanced liver disease were included in the study. Pulmonary function test, contrast echocardiography and arterial blood gases analyses and chest radiography were performed for all the patients. Patients with and without hepatopulmonary syndrome (HPS) as well as patients with and without severe hypoxemia (partial pressure of arterial oxygen, PaO(2)<60 mmHg) were compared regarding clinical and paraclinical characteristics.


RESULTS
The most common causes for liver disease were cryptogenic cirrhosis, biliary atresia and autoimmune cirrhosis. Clubbing (n=27) and cyanosis (n=9) were the most common abnormalities in physical exam. Nine patients (11.4%) were found to have HPS. PaO(2) was 52.9 ± 10.4 mmHg in HPS patients while it was 73.7 ± 28 mmHg in non-HPS patients (p=0.03). Twenty eight patients had severe hypoxemia. Partial pressure of arterial carbon dioxide (PaCO(2)) was higher among patients with severe hypoxemia (p=0.001).


CONCLUSIONS
Pulmonary evaluation must be performed in all pediatric patients before LT. HPS is not so common among pediatric patients while hypoxemic patients may include a larger proportion of pediatric patients listing for LT.
Dehghani
Seyed Mohsen
SM
Pediatric Gastroenterology, Shiraz University of Medical Sciences, Shiraz, Iran. dehghanism@sums.ac.ir
Aleyasin
Soheyla
S
Honar
Naser
N
Eshraghian
Ahad
A
Kashef
Sara
S
Haghighat
Mahmood
M
Malek-Hosseini
Seyed Ali
SA
D000293:Adolescent; D002245:Carbon Dioxide / Q000097:blood; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography; D058625:End Stage Liver Disease / Q000097:blood / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D005541:Forced Expiratory Volume; D020065:Hepatopulmonary Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D000860:Hypoxia / Q000175:diagnosis / Q000453:epidemiology; D007492:Iran; D016031:Liver Transplantation; D008297:Male; D010100:Oxygen / Q000097:blood; D011446:Prospective Studies; D012129:Respiratory Function Tests; D013147:Spirometry; D014797:Vital Capacity
D002245:Carbon Dioxide; D010100:Oxygen