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Diaphragmatic nerve palsy in young children following liver transplantation

Successful treatment by plication of the diaphragm

  • ORIGINAL ARTICLE
  • Published:
Transplant International

Abstract

Diaphragmatic paralysis was identified in four children after liver transplantation. All presented with persistent right upper lobe atelectasis, pleural effusion and recurrent respiratory infections and could not be weaned from mechanical ventilatory support. Fluoroscopy and real-time ultrasound confirmed paradoxical right diaphragmatic movements. Diaphragmatic plication was undertaken and enabled rapid and sustained weaning from respiratory support in all four cases. Vascular clamping of the suprahepatic vena cava seems to be the cause. Diaphragmatic plication allows optimal recruitment of the respiratory muscles with a favourable impact on lung mechanics and gas exchange.

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Authors and Affiliations

  1. Liver Transplant Surgical Service, King's College Hospital, Denmark Hill, London SE5 9RS, UK Fax: + 44 171 346 3575, , , , , , DK

    V Smyrniotis, P. Andreani, P. Muiesan, M. Rela & N. D. Heaton

  2. Department of Child Health, King's College Hospital Denmark Hill, London SE5 9RS, UK, , , , , , DK

    G. Mieli-Vergani

Authors
  1. V Smyrniotis
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  2. P. Andreani
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  3. P. Muiesan
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  4. G. Mieli-Vergani
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  5. M. Rela
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  6. N. D. Heaton
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Additional information

Received: 31 December 1997 Received after revision: 27 March 1998 Accepted: 17 April 1998

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Smyrniotis, V., Andreani, P., Muiesan, P. et al. Diaphragmatic nerve palsy in young children following liver transplantation . Transpl Int 11, 281–283 (1998). https://doi.org/10.1007/s001470050142

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  • DOI: https://doi.org/10.1007/s001470050142

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