Overcoming Intrapulmonary Shunting: A Case Report of Hepatopulmonary Syndrome Post‐Liver Transplantation Treated With Inhaled Treprostinil
ABSTRACT Hepatopulmonary syndrome (HPS) poses a significant challenge in liver transplant recipients, mostly resulting in persistent hypoxaemia postoperatively. We present the case of a 59‐year‐old male with decompensated metabolic dysfunction associated with steatohepatitis (MASH) cirrhosis, who ha...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2025-05-01
|
| Series: | Respirology Case Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/rcr2.70204 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850108391223984128 |
|---|---|
| author | John Fanous Dakota McNierney Abdelmohaymin Abdalla Jehad Azar |
| author_facet | John Fanous Dakota McNierney Abdelmohaymin Abdalla Jehad Azar |
| author_sort | John Fanous |
| collection | DOAJ |
| description | ABSTRACT Hepatopulmonary syndrome (HPS) poses a significant challenge in liver transplant recipients, mostly resulting in persistent hypoxaemia postoperatively. We present the case of a 59‐year‐old male with decompensated metabolic dysfunction associated with steatohepatitis (MASH) cirrhosis, who had liver transplantation due to end‐stage liver disease complicated by HPS‐related hypoxaemia. Despite successful transplantation, the patient continued to experience severe hypoxaemia, requiring high supplemental oxygen despite maximal conservative treatment per guidelines. Potential causes for hypoxaemia post‐liver transplant have been excluded; HPS as the sole cause of hypoxaemia was proved with a repeat shunt study, which estimated the shunt at 59%. Treatment with inhaled Treprostinil led to a remarkable improvement in oxygenation, facilitating the successful weaning of oxygen supplementation. The patient's hypoxaemia improved to full recovery upon discharge. This case highlights the persistence of hypoxaemia post‐liver transplantation in HPS patients and underscores the potential role of inhaled Treprostinil as a novel therapeutic approach to address this complication. |
| format | Article |
| id | doaj-art-5e2cfb8b4bbe4492bdbcb0d0eaddc460 |
| institution | OA Journals |
| issn | 2051-3380 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Wiley |
| record_format | Article |
| series | Respirology Case Reports |
| spelling | doaj-art-5e2cfb8b4bbe4492bdbcb0d0eaddc4602025-08-20T02:38:22ZengWileyRespirology Case Reports2051-33802025-05-01135n/an/a10.1002/rcr2.70204Overcoming Intrapulmonary Shunting: A Case Report of Hepatopulmonary Syndrome Post‐Liver Transplantation Treated With Inhaled TreprostinilJohn Fanous0Dakota McNierney1Abdelmohaymin Abdalla2Jehad Azar3Department of Pulmonary and Critical Care Medicine Mayo Clinic Phoenix Arizona USADepartment of Pulmonary and Critical Care Medicine Mayo Clinic Phoenix Arizona USADepartment of Pulmonary and Critical Care Medicine Mayo Clinic Phoenix Arizona USADepartment of Pulmonary and Critical Care Medicine Mayo Clinic Phoenix Arizona USAABSTRACT Hepatopulmonary syndrome (HPS) poses a significant challenge in liver transplant recipients, mostly resulting in persistent hypoxaemia postoperatively. We present the case of a 59‐year‐old male with decompensated metabolic dysfunction associated with steatohepatitis (MASH) cirrhosis, who had liver transplantation due to end‐stage liver disease complicated by HPS‐related hypoxaemia. Despite successful transplantation, the patient continued to experience severe hypoxaemia, requiring high supplemental oxygen despite maximal conservative treatment per guidelines. Potential causes for hypoxaemia post‐liver transplant have been excluded; HPS as the sole cause of hypoxaemia was proved with a repeat shunt study, which estimated the shunt at 59%. Treatment with inhaled Treprostinil led to a remarkable improvement in oxygenation, facilitating the successful weaning of oxygen supplementation. The patient's hypoxaemia improved to full recovery upon discharge. This case highlights the persistence of hypoxaemia post‐liver transplantation in HPS patients and underscores the potential role of inhaled Treprostinil as a novel therapeutic approach to address this complication.https://doi.org/10.1002/rcr2.70204hepatopulmonary syndromeintrapulmonary shuntingliver transplantationTreprostinil |
| spellingShingle | John Fanous Dakota McNierney Abdelmohaymin Abdalla Jehad Azar Overcoming Intrapulmonary Shunting: A Case Report of Hepatopulmonary Syndrome Post‐Liver Transplantation Treated With Inhaled Treprostinil Respirology Case Reports hepatopulmonary syndrome intrapulmonary shunting liver transplantation Treprostinil |
| title | Overcoming Intrapulmonary Shunting: A Case Report of Hepatopulmonary Syndrome Post‐Liver Transplantation Treated With Inhaled Treprostinil |
| title_full | Overcoming Intrapulmonary Shunting: A Case Report of Hepatopulmonary Syndrome Post‐Liver Transplantation Treated With Inhaled Treprostinil |
| title_fullStr | Overcoming Intrapulmonary Shunting: A Case Report of Hepatopulmonary Syndrome Post‐Liver Transplantation Treated With Inhaled Treprostinil |
| title_full_unstemmed | Overcoming Intrapulmonary Shunting: A Case Report of Hepatopulmonary Syndrome Post‐Liver Transplantation Treated With Inhaled Treprostinil |
| title_short | Overcoming Intrapulmonary Shunting: A Case Report of Hepatopulmonary Syndrome Post‐Liver Transplantation Treated With Inhaled Treprostinil |
| title_sort | overcoming intrapulmonary shunting a case report of hepatopulmonary syndrome post liver transplantation treated with inhaled treprostinil |
| topic | hepatopulmonary syndrome intrapulmonary shunting liver transplantation Treprostinil |
| url | https://doi.org/10.1002/rcr2.70204 |
| work_keys_str_mv | AT johnfanous overcomingintrapulmonaryshuntingacasereportofhepatopulmonarysyndromepostlivertransplantationtreatedwithinhaledtreprostinil AT dakotamcnierney overcomingintrapulmonaryshuntingacasereportofhepatopulmonarysyndromepostlivertransplantationtreatedwithinhaledtreprostinil AT abdelmohayminabdalla overcomingintrapulmonaryshuntingacasereportofhepatopulmonarysyndromepostlivertransplantationtreatedwithinhaledtreprostinil AT jehadazar overcomingintrapulmonaryshuntingacasereportofhepatopulmonarysyndromepostlivertransplantationtreatedwithinhaledtreprostinil |