The Successful Use of Inhaled Nitric Oxide in the Management of Severe Hepatopulmonary Syndrome after Orthotopic Liver Transplantation
Hepatopulmonary syndrome (HPS) is characterized by pulmonary vasodilation and subsequent hypoxemia in the setting of hepatic dysfunction. There is currently no pharmacologic intervention that has been shown to significantly affect outcomes and liver transplantation remains the mainstay of therapy....
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| Format: | Article |
| Language: | English |
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Wiley
2014-01-01
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| Series: | Case Reports in Hepatology |
| Online Access: | http://dx.doi.org/10.1155/2014/415109 |
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| author | Joshua Santos Philip Young Igor Barjaktarevic Catherine Lazar Irawan Susanto Tisha Wang |
| author_facet | Joshua Santos Philip Young Igor Barjaktarevic Catherine Lazar Irawan Susanto Tisha Wang |
| author_sort | Joshua Santos |
| collection | DOAJ |
| description | Hepatopulmonary syndrome (HPS) is characterized by pulmonary vasodilation and subsequent hypoxemia in the setting of hepatic dysfunction. There is currently no pharmacologic intervention that has been shown to significantly affect outcomes and liver transplantation remains the mainstay of therapy. Unfortunately, patients undergoing liver transplantation are at high risk of significant hypoxemia and mortality in the early postoperative period. In the following case series, we present two cases of patients with severe HPS who underwent liver transplantation and experienced marked hypoxemia in the early postoperative period. In both cases, we successfully treated the patients with inhaled nitric oxide for their severe refractory life-threatening hypoxemia which led to immediate and dramatic improvements in their oxygenation. Although the use of inhaled nitric oxide in patients with HPS has been sporadically reported in pediatric literature and in animal studies, to our knowledge, our cases are the first recorded in adult patients. |
| format | Article |
| id | doaj-art-415ae9469d3b423eb344e25990cff137 |
| institution | Kabale University |
| issn | 2090-6587 2090-6595 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Hepatology |
| spelling | doaj-art-415ae9469d3b423eb344e25990cff1372025-02-03T01:24:26ZengWileyCase Reports in Hepatology2090-65872090-65952014-01-01201410.1155/2014/415109415109The Successful Use of Inhaled Nitric Oxide in the Management of Severe Hepatopulmonary Syndrome after Orthotopic Liver TransplantationJoshua Santos0Philip Young1Igor Barjaktarevic2Catherine Lazar3Irawan Susanto4Tisha Wang5Department of Internal Medicine, David Geffen School of Medicine, the University of California Los Angeles, UCLA Med-Admin, Box 951736, 37120 CHS, Los Angeles, CA 90095-1736, USADepartment of Internal Medicine, David Geffen School of Medicine, the University of California Los Angeles, UCLA Med-Admin, Box 951736, 37120 CHS, Los Angeles, CA 90095-1736, USADivision of Pulmonary, Critical Care, and Sleep Medicine, David Geffen School of Medicine, the University of California Los Angeles, 10833 Le Conte Avenue, Room 37-131 CHS, Los Angeles, CA 90095-1690, USADivision of Pulmonary, Critical Care, and Sleep Medicine, David Geffen School of Medicine, the University of California Los Angeles, 10833 Le Conte Avenue, Room 37-131 CHS, Los Angeles, CA 90095-1690, USADivision of Pulmonary, Critical Care, and Sleep Medicine, David Geffen School of Medicine, the University of California Los Angeles, 10833 Le Conte Avenue, Room 37-131 CHS, Los Angeles, CA 90095-1690, USADivision of Pulmonary, Critical Care, and Sleep Medicine, David Geffen School of Medicine, the University of California Los Angeles, 10833 Le Conte Avenue, Room 37-131 CHS, Los Angeles, CA 90095-1690, USAHepatopulmonary syndrome (HPS) is characterized by pulmonary vasodilation and subsequent hypoxemia in the setting of hepatic dysfunction. There is currently no pharmacologic intervention that has been shown to significantly affect outcomes and liver transplantation remains the mainstay of therapy. Unfortunately, patients undergoing liver transplantation are at high risk of significant hypoxemia and mortality in the early postoperative period. In the following case series, we present two cases of patients with severe HPS who underwent liver transplantation and experienced marked hypoxemia in the early postoperative period. In both cases, we successfully treated the patients with inhaled nitric oxide for their severe refractory life-threatening hypoxemia which led to immediate and dramatic improvements in their oxygenation. Although the use of inhaled nitric oxide in patients with HPS has been sporadically reported in pediatric literature and in animal studies, to our knowledge, our cases are the first recorded in adult patients.http://dx.doi.org/10.1155/2014/415109 |
| spellingShingle | Joshua Santos Philip Young Igor Barjaktarevic Catherine Lazar Irawan Susanto Tisha Wang The Successful Use of Inhaled Nitric Oxide in the Management of Severe Hepatopulmonary Syndrome after Orthotopic Liver Transplantation Case Reports in Hepatology |
| title | The Successful Use of Inhaled Nitric Oxide in the Management of Severe Hepatopulmonary Syndrome after Orthotopic Liver Transplantation |
| title_full | The Successful Use of Inhaled Nitric Oxide in the Management of Severe Hepatopulmonary Syndrome after Orthotopic Liver Transplantation |
| title_fullStr | The Successful Use of Inhaled Nitric Oxide in the Management of Severe Hepatopulmonary Syndrome after Orthotopic Liver Transplantation |
| title_full_unstemmed | The Successful Use of Inhaled Nitric Oxide in the Management of Severe Hepatopulmonary Syndrome after Orthotopic Liver Transplantation |
| title_short | The Successful Use of Inhaled Nitric Oxide in the Management of Severe Hepatopulmonary Syndrome after Orthotopic Liver Transplantation |
| title_sort | successful use of inhaled nitric oxide in the management of severe hepatopulmonary syndrome after orthotopic liver transplantation |
| url | http://dx.doi.org/10.1155/2014/415109 |
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