TY - JOUR
T1 - Living-related liver transplantation in a patient with hepatopulmonary syndrome
AU - Matsumi, Masaki
AU - Kaku, Ryuji
AU - Fujii, Hiromi
AU - Kajiwara, Hidetoshi
AU - Sasaki, Toshihiro
AU - Satoh, Tetsufumi
AU - Ohashi, Ichiro
AU - Morita, Kiyoshi
PY - 2004/6/1
Y1 - 2004/6/1
N2 - We experienced the perioperative management of the living related liver transplantation (LRLT) in a patient with hepatopulmonary syndrome (HPS). HPS is seen in 15% of patients of the endstage liver failure, and it accompanies the various types of hypoxia. The diagnostic standards of HPS are chronic liver disease usually complicated by portal hypertension with or without cirrhosis, arterial hypoxemia (PaO2<70 mmHg or A-aDO2 gradient> 20 mmHg), and intrapulmonary vascular dilation. The present case conformed to the diagnostic standard. But this case was of a mild type of HPS, because PaO2 was elevated after O2 inhalation and extrapulmonary uptake of 99mTcMAA after lung perfusion was lower than 40%. During perioperative period of LRLT, there were no complications such as hypoxia, acute rejection, bleeding and infection. Therefore HPS would be improved after LRLT. In the management of perioperative period it is important to be aware of hypoxia and to evaluate preoperatively the condition of the patient properly.
AB - We experienced the perioperative management of the living related liver transplantation (LRLT) in a patient with hepatopulmonary syndrome (HPS). HPS is seen in 15% of patients of the endstage liver failure, and it accompanies the various types of hypoxia. The diagnostic standards of HPS are chronic liver disease usually complicated by portal hypertension with or without cirrhosis, arterial hypoxemia (PaO2<70 mmHg or A-aDO2 gradient> 20 mmHg), and intrapulmonary vascular dilation. The present case conformed to the diagnostic standard. But this case was of a mild type of HPS, because PaO2 was elevated after O2 inhalation and extrapulmonary uptake of 99mTcMAA after lung perfusion was lower than 40%. During perioperative period of LRLT, there were no complications such as hypoxia, acute rejection, bleeding and infection. Therefore HPS would be improved after LRLT. In the management of perioperative period it is important to be aware of hypoxia and to evaluate preoperatively the condition of the patient properly.
KW - Hepatopulmonary syndrome (HPS)
KW - Hypoxemia
KW - Living related liver transplantation
UR - http://www.scopus.com/inward/record.url?scp=3142556101&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=3142556101&partnerID=8YFLogxK
M3 - Article
C2 - 15242041
AN - SCOPUS:3142556101
VL - 53
SP - 668
EP - 671
JO - Japanese Journal of Anesthesiology
JF - Japanese Journal of Anesthesiology
SN - 0021-4892
IS - 6
ER -