title: Pulmonary evaluation in pediatric liver transplant candidates.
abstract: 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.
authors.affiliation: Pediatric Gastroenterology, Shiraz University of Medical Sciences, Shiraz, Iran. dehghanism@sums.ac.ir
authors.forename: Seyed Mohsen
authors.initials: SM
authors.lastname: Dehghani
authors.forename: Soheyla
authors.initials: S
authors.lastname: Aleyasin
authors.forename: Naser
authors.initials: N
authors.lastname: Honar
authors.forename: Ahad
authors.initials: A
authors.lastname: Eshraghian
authors.forename: Sara
authors.initials: S
authors.lastname: Kashef
authors.forename: Mahmood
authors.initials: M
authors.lastname: Haghighat
authors.forename: Seyed Ali
authors.initials: SA
authors.lastname: Malek-Hosseini
mesh_terms: 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
chemical_list: D002245:Carbon Dioxide; D010100:Oxygen