Pediatric Surgery International

, Volume 27, Issue 8, pp 817–821

Pediatric living donor liver transplantation for biliary atresia with hepatopulmonary syndrome: the gift of a second wind

Authors

    • Department of Transplant SurgeryJichi Medical University
  • Koichi Mizuta
    • Department of Transplant SurgeryJichi Medical University
  • Yukihiro Sanada
    • Department of Transplant SurgeryJichi Medical University
  • Minoru Umehara
    • Department of Transplant SurgeryJichi Medical University
  • Taiichi Wakiya
    • Department of Transplant SurgeryJichi Medical University
  • Shuji Hishikawa
    • Department of Transplant SurgeryJichi Medical University
  • Masanobu Hyodo
    • Department of Gastrointestinal SurgeryJichi Medical University
  • Yasunaru Sakuma
    • Department of Gastrointestinal SurgeryJichi Medical University
  • Takehito Fujiwara
    • Department of Gastrointestinal SurgeryJichi Medical University
  • Yoshikazu Yasuda
    • Department of Gastrointestinal SurgeryJichi Medical University
  • Hideo Kawarasaki
    • Department of Transplant SurgeryJichi Medical University
Original Article

DOI: 10.1007/s00383-011-2866-8

Cite this article as:
Urahashi, T., Mizuta, K., Sanada, Y. et al. Pediatr Surg Int (2011) 27: 817. doi:10.1007/s00383-011-2866-8

Abstract

Purpose

Hepatopulmonary syndrome (HPS) is a progressive, deteriorating complication of end-stage liver disease (ESLD) that occurs in 13–47% of liver transplant candidates. Although LT is the only therapeutic option for HPS, it has a high morbidity and mortality, especially in patients with severe hypoxemia before transplantation, but the course of HPS after living donor liver transplantation (LDLT), especially for biliary atresia (BA) patients is not well established.

Patients and methods

The present study evaluated 122 patients who received an LDLT for BA and of these, 3 patients had HPS at the time of LDLT in a single-center series.

Results

Two patients of the HPS patients them had biliary and/or vascular complications, but they recovered uneventfully with interventional treatment. None of the patients required supplemental oxygen and had no residual cardiopulmonary abnormalities at a follow-up of more than 24 months.

Conclusion

Although a series of three patients is too small for definitive conclusion and further investigations must be conducted, pediatric LDLT can be a favorable therapeutic option for HPS.

Keywords

Pediatric living donor liver transplantationBiliary atresiaHepatopulmonary syndrome

Abbreviations

LT

Liver transplantation

LDLT

Living donor liver transplantation

HPS

Hepatopulmonary syndrome

PELD

Pediatric model for end-stage liver disease

NM

Nuclear medicine

SpO2

Percent oxygen saturation

PaO2

Partial pressure of arterial oxygen

MMA

Macroaggregated albumin

CE

Contrast enhanced

Copyright information

© Springer-Verlag 2011