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Hepatopulmonary syndrome in candidates for liver transplantation.

Abstract：

BACKGROUND:Hepatopulmonary syndrome (HPS) has been defined as a clinical triad, including chronic liver disease, gas exchange defects (increased alveolar-arterial PO2 difference irrespective of the presence of arterial hypoxemia), and widespread intrapulmonary vascular dilatations. We determined the incidence and the clinical and pulmonary functional characteristics of HPS in candidates for orthotopic liver transplantation (OLT) and tested their predicted accuracy. METHODS:We studied 80 patients with cirrhosis prospectively, and carried out contrast-enhanced (CE) echocardiography and lung function tests, including ventilation-perfusion (V(A)/Q) distributions. RESULTS:Fourteen patients had HPS (incidence, 17.5%). Patients with HPS (49 +/- 12 (+/-SD) years) had more cutaneous spiders, finger clubbing and dyspnea (P < 0.05 each) and a lower diffusing capacity (DLCO, 56 +/- 18% predicted; P < 0.001) than non-HPS patients (n = 66). Mild to moderate V(A)/Q inequalities and increased intrapulmonary shunt were predominant in HPS patients, but oxygen diffusion impairment was observed in those with hypoxemia (n = 8) only. The DLCO showed a considerable area under the receiver operating characteristic curve (0.89). CONCLUSIONS:HPS in cirrhotic patient candidates for OLT shows a high incidence and these patients present with distinctive clinical and functional features compared with non-HPS individuals. The presence of a low DLCO may be of help for the diagnosis of HPS.

journal_name

J Hepatol

journal_title

Journal of hepatology

authors

Martínez GP,Barberà JA,Visa J,Rimola A,Paré JC,Roca J,Navasa M,Rodés J,Rodriguez-Roisin R

doi

10.1016/s0168-8278(00)00108-2

subject

Has Abstract

pub_date

2001-05-01 00:00:00

pages

651-7

issue

5

eissn

0168-8278

issn

1600-0641

pii

S0168-8278(00)00108-2

journal_volume

34

pub_type

杂志文章

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