Document Detail


Review article: liver transplantation for the pulmonary disorders of portal hypertension.
MedLine Citation:
PMID:  23146100     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Liver transplantation is potentially a life-saving therapeutic intervention for patients with portopulmonary hypertension and hepatopulmonary syndrome. However, due to limited data, listing criteria for patients with these conditions have not been clearly established. Indeed, this has led some to speculate that transplantation may not be appropriate in cases of moderate-to-severe portopulmonary hypertension and severe hepatopulmonary syndrome.
AIM: To critically discuss the utility of LT for the treatment of hepatopulmonary syndrome and portopulmonary hypertension.
METHODS: A literature search was conducted in 2012 on PubMed, Ovid Embase, Ovid Medline and Scopus using the following search terms: hepatopulmonary syndrome, portopulmonary hypertension, pulmonary arterial hypertension, liver transplantation. Relevant manuscripts were included in the review.
RESULTS: Liver transplantation has established itself as an effective treatment for selected patients with hepatopulmonary syndrome and portopulmonary hypertension. A multidisciplinary team approach incorporating focused strategies (both pre- and post-operatively) aimed at improving oxygenation in patients with hepatopulmonary syndrome has led to a dramatic improvement in patient outcomes. Additionally, careful patient selection and the use of targeted pulmonary vascular therapies are successfully being used to treat portopulmonary hypertension and 'bridge' patients to successful liver transplantation.
CONCLUSIONS: Liver transplantation is an effective therapy for patients with hepatopulmonary syndrome and portopulmonary hypertension. However, rigorous screening and early identification of these conditions allied with aggressive pre-operative optimisation of physiology and diligent post-operative care are imperative to ensuring a good outcome.
Authors:
D D Houlihan; A Holt; C Elliot; J W Ferguson
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review     Date:  2012-11-12
Journal Detail:
Title:  Alimentary pharmacology & therapeutics     Volume:  37     ISSN:  1365-2036     ISO Abbreviation:  Aliment. Pharmacol. Ther.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2012-12-20     Completed Date:  2013-05-24     Revised Date:  2014-02-20    
Medline Journal Info:
Nlm Unique ID:  8707234     Medline TA:  Aliment Pharmacol Ther     Country:  England    
Other Details:
Languages:  eng     Pagination:  183-94     Citation Subset:  IM    
Copyright Information:
© 2012 Blackwell Publishing Ltd.
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MeSH Terms
Descriptor/Qualifier:
Hepatopulmonary Syndrome / etiology,  surgery*
Humans
Hypertension, Portal / complications,  surgery*
Hypertension, Pulmonary / etiology,  surgery*
Liver Transplantation / methods*,  standards
Patient Selection
Postoperative Complications / prevention & control
Risk Assessment
Severity of Illness Index
Grant Support
ID/Acronym/Agency:
G0802350//Medical Research Council; //Medical Research Council

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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