title: Pediatric living donor liver transplantation for biliary atresia with hepatopulmonary syndrome: the gift of a second wind.
abstract: OBJECTIVE
  Hepatopulmonary syndrome (HPS) is a progressive, deteriorating complication of end-stage liver disease (ESLD) that occurs in 13-47% of liver transplant candidates. Although LT is the only therapeutic option for HPS, it has a high morbidity and mortality, especially in patients with severe hypoxemia before transplantation, but the course of HPS after living donor liver transplantation (LDLT), especially for biliary atresia (BA) patients is not well established.
  
  
  METHODS
  The present study evaluated 122 patients who received an LDLT for BA and of these, 3 patients had HPS at the time of LDLT in a single-center series.
  
  
  RESULTS
  Two patients of the HPS patients them had biliary and/or vascular complications, but they recovered uneventfully with interventional treatment. None of the patients required supplemental oxygen and had no residual cardiopulmonary abnormalities at a follow-up of more than 24 months.
  
  
  CONCLUSIONS
  Although a series of three patients is too small for definitive conclusion and further investigations must be conducted, pediatric LDLT can be a favorable therapeutic option for HPS.
authors.affiliation: Department of Transplant Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan. turahashi@jichi.ac.jp
authors.forename: Taizen
authors.initials: T
authors.lastname: Urahashi
authors.forename: Koichi
authors.initials: K
authors.lastname: Mizuta
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Sanada
authors.forename: Minoru
authors.initials: M
authors.lastname: Umehara
authors.forename: Taiichi
authors.initials: T
authors.lastname: Wakiya
authors.forename: Shuji
authors.initials: S
authors.lastname: Hishikawa
authors.forename: Masanobu
authors.initials: M
authors.lastname: Hyodo
authors.forename: Yasunaru
authors.initials: Y
authors.lastname: Sakuma
authors.forename: Takehito
authors.initials: T
authors.lastname: Fujiwara
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Yasuda
authors.forename: Hideo
authors.initials: H
authors.lastname: Kawarasaki
mesh_terms: D000293:Adolescent; D000328:Adult; D001656:Biliary Atresia / Q000150:complications / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D020065:Hepatopulmonary Syndrome / Q000209:etiology / Q000601:surgery*; D006801:Humans; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D010290:Parents; D012189:Retrospective Studies; D009927:Tissue and Organ Procurement