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Early liver transplantation is crucial in children with liver disease and pulmonary artery hypertension

Authors :
Yves Ozier
Jean Losay
Denis Devictor
Joelle Bougaran
Dominique Piot
Olivier Bernard
Didier Houssin
Source :
Journal of Hepatology. 28:337-342
Publication Year :
1998
Publisher :
Elsevier BV, 1998.

Abstract

Background/Aims: Early liver transplantation is crucial in children with liver disease and pulmonary artery hypertension. Some severe pulmonary vascular anomalies associated with portal hypertension disappear after isolated liver transplantation. Evolution of pulmonary artery hypertension due to plexogenic arteriopathy is controversial, as this association is still considered a contraindication to isolated liver transplantation. Outcome of pulmonary hypertension after isolated liver transplantation is reported in three patients with portal hypertension. Methods: After echocardiographic diagnosis, the patients had a complete hemodynamic exploration, and two had a lung biopsy. After liver transplantation, the survivors had echocardiographic follow up and a second hemodynamic exploration. Results: In two children, pulmonary pressures and resistances returned to near-normal values 1 and 6 years after successful isolated liver transplantation. The third patient, with the most severe arteriopathy, had to wait 1 year for a donor, and the attempted transplantation was complicated by ventricular tachycardia; death occurred 2 days after surgery. Conclusions: Liver transplantation can reverse pulmonary artery hypertension due to high pulmonary resistances complicating liver disease with portal hypertension, provided it is carried out at an early stage. Early detection of pulmonary hypertension by systematic echocardiography may thus be crucial in these children with portal hypertension.

Details

ISSN :
01688278
Volume :
28
Database :
OpenAIRE
Journal :
Journal of Hepatology
Accession number :
edsair.doi.dedup.....b2ad0d871ed725e1b5bc4e20d8fa3828
Full Text :
https://doi.org/10.1016/0168-8278(88)80022-9