Pediatric Surgery International

, Volume 27, Issue 8, pp 817–821 | Cite as

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

  • Taizen Urahashi
  • Koichi Mizuta
  • Yukihiro Sanada
  • Minoru Umehara
  • Taiichi Wakiya
  • Shuji Hishikawa
  • Masanobu Hyodo
  • Yasunaru Sakuma
  • Takehito Fujiwara
  • Yoshikazu Yasuda
  • Hideo Kawarasaki
Original Article



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.


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.


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.


Pediatric living donor liver transplantation Biliary atresia Hepatopulmonary syndrome 



Liver transplantation


Living donor liver transplantation


Hepatopulmonary syndrome


Pediatric model for end-stage liver disease


Nuclear medicine


Percent oxygen saturation


Partial pressure of arterial oxygen


Macroaggregated albumin


Contrast enhanced


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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Taizen Urahashi
    • 1
  • Koichi Mizuta
    • 1
  • Yukihiro Sanada
    • 1
  • Minoru Umehara
    • 1
  • Taiichi Wakiya
    • 1
  • Shuji Hishikawa
    • 1
  • Masanobu Hyodo
    • 2
  • Yasunaru Sakuma
    • 2
  • Takehito Fujiwara
    • 2
  • Yoshikazu Yasuda
    • 2
  • Hideo Kawarasaki
    • 1
  1. 1.Department of Transplant SurgeryJichi Medical UniversityShimotsukeJapan
  2. 2.Department of Gastrointestinal SurgeryJichi Medical UniversityShimotsukeJapan

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