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Excellent outcome of living donor liver transplantation in patients with hepatopulmonary syndrome: a single centre experience
Author(s) -
Saigal Sanjiv,
Choudhary Narendra,
Saraf Neeraj,
Kotecha Hardik,
Kakodkar Rahul,
Mohanka Ravi,
Rastogi Amit,
Me Palat,
Goja Sanjay,
Govil Deepak,
Vohra Vijay,
Soin Arvinder
Publication year - 2013
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12126
Subject(s) - medicine , hepatopulmonary syndrome , cirrhosis , liver transplantation , surgery , liver disease , gastroenterology , transplantation , single center , model for end stage liver disease
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 . Methods Fourteen patients with HPS and cirrhosis who underwent LDLT were prospectively included. HPS was defined as PaO 2 < 80 mmHg in presence of demonstrable macro‐aggregated albumin ( MAA ) scan shunt fraction >6%. Results 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 PaO 2 was 58.7 ± 8.4 mmHg. Two patients had very severe HPS (PaO 2 <50 mmHg), five had severe HPS (PaO 2 >50 <60 mmHg) and seven had moderate HPS (PaO 2 >60 <80 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. Conclusion We report one of the largest series of LDLT in HPS which has shown excellent results.