title: The impact of intrapulmonary shunting after liver transplantation in pediatric patients.
abstract: OBJECTIVE
  Intrapulmonary shunting (IPS) due to pulmonary vascular dilatation is frequently observed among patients with end-stage liver disease (ESLD). This study investigated the prevalence and impact of IPS after liver transplantation (LT) in children.
  
  
  METHODS
  A total of 77 pediatric patients who underwent primary LT were enrolled. All patients had trans-thoracic contrast echocardiography before LT and at least 1 year after transplantation. The patients with IPS and without IPS after LT were designated as group 1 and group 2, respectively.
  
  
  RESULTS
  The prevalence of IPS after LT was 6.1%. The patients in group 1 (n=5) were younger (6.4 +/- 2.8 vs. 9.9 +/- 3.6, p=0.036) than in group 2 (n=72). There were no significant differences in gender, weight, hemoglobin level, O(2) saturation, or complications between the two groups. Fourteen patients had abnormal liver function tests, two patients in group 1 and 12 patients in group 2 (p=0.22).The overall follow-up period was 6.7 +/- 2.7 years (range, 1.6-13.0). At the latest follow-up, all 5 patients with mild IPS after LT remain asymptomatic with good liver graft function.
  
  
  CONCLUSIONS
  Among pediatric ESLD patients with preoperative IPS, approximately 6% continue to have mild IPS after LT. Patients with mild IPS after LT remain asymptomatic and have good liver graft function.
authors: Liver Transplantation Program, Chang Gung Memorial Hospital-Kaohsiung Medical Center, and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors: Chi-Di
authors: CD
authors: Liang
authors: Allan
authors: A
authors: Concejero
authors: Sheung-Fat
authors: SF
authors: Ko
authors: Chih-Cheng
authors: CC
authors: Chen
authors: Chih-Chi
authors: CC
authors: Wang
authors: Chao-Long
authors: CL
authors: Chen
mesh_terms: D002648:Child; D002675:Child, Preschool; D004452:Echocardiography; D058625:End Stage Liver Disease / Q000150:complications / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D020065:Hepatopulmonary Syndrome / Q000150:complications / Q000503:physiopathology*; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D011652:Pulmonary Circulation; D016896:Treatment Outcome