Intrapulmonary vascular dilation in children with chronic liver diseases: pre- and post-liver transplantation
Journal Title: Annals of Hepatology - Year 2016, Vol 15, Issue 1
Abstract
Background and study aims. Chronic liver disease (CLD) can cause hepatopulmonary syndrome (HPS), defined as triad of liver disease, hypoxemia, and intrapulmonary vascular dilation (IPVD). The aim of this study was to determine the evidence of IPVD in a cohort of pediatric patients with CLD pre- and post-liver transplantation (LT). Material and methods. All pediatric patients with CLD listed for LT were studied. Pulse oxygen saturation (SpO2), technetium-99m–labeled macroaggregated albumin (99mTc- MAA) perfusión scan (positive test: uptake of the isotope ≥ 6% in the brain), and echocardiography with saline bubble test(SBT) were performed. SBT was re-evaluated at 3-6 months after LT. Grading of SBT included grade 0 (no bubble), I (1-9 bubbles), grade II (10-20 bubbles), and grade III (> 20 bubbles). Results. Eighteen patients, median age 22.5 months (8-108), were enrolled. Most had biliary atresia (77.8%). Pre-LT, all patients hadSpO2 of 100% and none had positive 99mTc- MAA perfusion scan. Two patients (11%) had negative SBT (grade 0), 1 (5.5%) had grade I, 3 (16.5%) had grade II, and 12 (67%) had grade III, respectively. Post-LT SBT became negative in all survivors (n = 16), (p = 0.0001). Conclusions. Most cirrhotic children in this cohort study had evidence of IPVD by positive SBT. However, none of these met the criteria for diagnosis of HPS. This evidence of IPVD subsided after LT.
Authors and Affiliations
Anant Khositseth, Suporn Treepongkaruna, Khemika Khemakanok, Sumate Teeraratkul, Vichai Pansrimangkorn, Chollasak Thirapattaraphan, Surasak Leelaudomlipi
Keywords
Related Articles
- EP ID EP78536
- DOI 10.5604/16652681.1184207
- Views 114
- Downloads 0
Prevalence of insulin resistance in chronic hepatitis C genotype 1 and 3 patients
Background and rationale. Chronic infection with the hepatitis C virus (HCV) is associated with a higher prevalence of insulin resistance compared to the general population. This finding is associated with hepatic steato...
Hepatotoxicity from ingestion of wild mushrooms of the genus Amanita section Phalloideae collected in Mexico City: two case reports
We present two cases of acute liver injury resulting from consumption of wild mushrooms. The first case was a male who developed acute hepatitis after ingestion of diverse mushrooms including Amanita species. His clinica...
Short and long term outcome of kidney transplanted patients with chronic viral hepatitis B and C
Introduction. Liver disease related to chronic viral hepatitis is a major cause of morbidity and mortality in renal transplant patients. There is no agreement upon the influence of chronic hepatitis B (HBV) and hepatitis...
Mycophenolate mofetil in liver transplant patients with calcineurin-inhibitor-induced renal impairment
Background: Calcineurin inhibitors (CNIs) provide effective immunosuppression after orthotopic liver transplantation (OLTx), but the associated nephrotoxicity can cause substantial morbidity and mortality among transplan...
Rapid diagnosis of spontaneous bacterial peritonitis using leukocyte esterase reagent strips in Emergency Department: Uri-Quick Clini-10SG® vs. Multistix 10SG®
Background and aim. Bacterial peritonitis (SBP) is the most frequent infection in patients with cirrhosis causing significant mortality. Delay in SBP diagnosis is a serious problem. The aim of this study was to evaluate...