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Improvement of hepatopulmonary syndrome after transjugular intrahepatic portasystemic shunting: Case report and review of literature
Author(s) -
Paramesh Anil S.,
Husain Sohail Z.,
Shneider Benjamin,
Guller Jeffrey,
Tokat Ikbal,
Gondolesi Gabriel E.,
Moyer Susan,
Emre Sukru
Publication year - 2003
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1034/j.1399-3046.2003.00033.x
Subject(s) - hepatopulmonary syndrome , medicine , portal hypertension , liver transplantation , shunting , hypoxemia , liver disease , surgery , biliary atresia , gastroenterology , transplantation , cirrhosis
The hepatopulmonary syndrome has been described in as many as 5–29% of patients with liver disease. Patients with this syndrome may suffer from chronic hypoxemia, and mortality rates of liver patients with this syndrome are as high as 41%. Early diagnosis of such patients is essential. Currently, liver transplantation is the only effective therapy for such patients, and reversal of this syndrome is seen in up to 80% of patients post‐transplant. Transjugular intrahepatic portasystemic shunting (TIPS) as a therapeutic maneuver for this syndrome has been described in five patients to date with mixed results. Reduction in portal hypertension with consequent redistribution of blood flow and altered synthesis of vasodilatory chemicals have been postulated to help resolve this disease. In this report, we describe an 11‐yr‐old female with biliary atresia and hepatopulmonary syndrome. Her disease was complicated with recurrent variceal bleeding. TIPS achieved a therapeutic response of both her bleeding and respiratory complications.