title: Living donor liver transplantation for end-stage liver disease with severe hepatopulmonary syndrome: report of a case.
abstract: Hepatopulmonary syndrome (HPS) is a serious complication of terminal liver disease, which manifests as severe hypoxia without any pulmonary anatomic or functional causes. The precise indications for liver transplantation in patients with severe HPS also remain unclear. A 49-year old woman was referred to our department for investigation and management of liver cirrhosis with severe hypoxia (PaO(2), 38 mmHg). A pulmonary perfusion scintigram showed an intrapulmonary shunt ratio of 40%, confirming a diagnosis of severe HPS. She underwent living donor liver transplantation using a right lobe graft donated by her 27-year-old daughter. Her post-transplant graft function was excellent, and her oxygenation recovered slowly but steadily. She was discharged from hospital on posttransplant day 39 with an SpO(2) of 94% under 3 l/min of O(2), delivered nasally. Despite the severity of the HPS, her postoperative recovery was smooth after the liver transplant.
authors.affiliation: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Motomura
authors.forename: Toru
authors.initials: T
authors.lastname: Ikegami
authors.forename: Yohei
authors.initials: Y
authors.lastname: Mano
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Nagata
authors.forename: Keishi
authors.initials: K
authors.lastname: Sugimachi
authors.forename: Tomoharu
authors.initials: T
authors.lastname: Gion
authors.forename: Yuji
authors.initials: Y
authors.lastname: Soejima
authors.forename: Akinobu
authors.initials: A
authors.lastname: Taketomi
authors.forename: Ken
authors.initials: K
authors.lastname: Shirabe
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Maehara
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D020065:Hepatopulmonary Syndrome / Q000150:complications* / Q000601:surgery; D006801:Humans; D017093:Liver Failure / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008875:Middle Aged; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed