Excellent outcome of living donor liver transplantation in patients with hepatopulmonary syndrome: a single centre experience

Autor:	Ravi Mohanka, Deepak Govil, Sanjay Goja, Amit Rastogi, Arvinder S. Soin, Neeraj Saraf, Hardik Kotecha, Rahul Kakodkar, Sanjiv Saigal, P.B. Menon, Vijay Vohra, Narendra S. Choudhary
Rok vydání:	2013
Předmět:	Adult Male medicine.medical_specialty Cirrhosis medicine.medical_treatment Liver transplantation Severity of Illness Index Liver disease Model for End-Stage Liver Disease Living Donors medicine Humans In patient Hepatopulmonary syndrome Transplantation business.industry Middle Aged Prognosis medicine.disease Liver Transplantation Surgery Single centre Female business Living donor liver transplantation Follow-Up Studies Hepatopulmonary Syndrome
Zdroj:	Clinical Transplantation. 27:530-534
ISSN:	0902-0063
DOI:	10.1111/ctr.12126
Popis:	Hepatopulmonary syndrome (HPS) worsens the prognosis of cirrhosis and liver transplantation is only definitive treatment. There is paucity of data about role of living donor liver transplantation (LDLT) in HPS.Fourteen patients with HPS and cirrhosis who underwent LDLT were prospectively included. HPS was defined as PaO280 mmHg in presence of demonstrable macro-aggregated albumin (MAA) scan shunt fraction6%.The study group composed of 11 male and three female patients, mean age 50.3 ± 8.6 yr. Most common presentations were dyspnea (92.8%), cyanosis (78.5%) and clubbing (64.2%). Mean model for end-stage liver disease (MELD) score was 18.2 ± 4.7, mean MAA shunt fraction was 23.0 ± 13.2%, mean PaO2 was 58.7 ± 8.4 mmHg. Two patients had very severe HPS (PaO250 mmHg), five had severe HPS (PaO25060 mmHg) and seven had moderate HPS (PaO26080 mmHg). All patients underwent right lobe LDLT. The overall time to extubation was 2 (1-32 days) and for hospital stay was 20 (17-46 days). The main complications in post-LT course were infection in 57% (cytomegalovirus or bacterial). All the patients are alive and off oxygen at a mean follow up of 29 ± 25 months.We report one of the largest series of LDLT in HPS which has shown excellent results.
Databáze:	OpenAIRE
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