Liver transplantation in patients with severe portopulmonary hypertension treated with preoperative chronic intravenous epoprostenol

Henkie P. Tan, Jay S. Markowitz, Robert A. Montgomery, William T. Merritt, Andrew S. Klein, Paul J. Thuluvath, F. Fred Poordad, Warren R. Maley, Bradford Winters, Seda B. Akinci, Sean P. Gaine

Producción científica: Articlerevisión exhaustiva

70 Citas (Scopus)

Resumen

Portopulmonary hypertension (PPHTN) is no longer an absolute contraindication to orthotopic liver transplantation (OLT). The pre-OLT management of patients with PPHTN requires early diagnosis and chronic therapy with intravenous epoprostenol to decrease pulmonary vascular resistance (PVR). Close follow-up is necessary to reassess pulmonary artery pressures (PAPs) and evaluate right ventricular (RV) function. This assists in the optimal timing of OLT. Successful management also necessitates reassessment of pulmonary artery hemodynamics just before OLT, with clearly defined parameters used to determine whether to proceed. Even with the intraoperative and postoperative availability of potent pulmonary vasodilators, clinical management may be suboptimal in reducing PAP. Adequate reduction in PVR and improvement in RV function in response to chronic epoprostenol therapy may facilitate successful OLT. We present a case report and review the limited experience with this treatment.

Idioma originalEnglish (US)
Páginas (desde-hasta)745-749
Número de páginas5
PublicaciónLiver Transplantation
Volumen7
N.º8
DOI
EstadoPublished - 2001
Publicado de forma externa

ASJC Scopus subject areas

  • Transplantation
  • Surgery
  • Hepatology

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