Frequency and significance of intrapulmonary right-to-left shunting in end-stage hepatic disease

Clinical predictors and characteristics of patients with chronic liver disease and intrapulmonary shunts

“…The overall prevalence of IPS (56%) in our study is greater than that described previously in smaller publications. 5,6 Consistent with earlier studies, there were no differences in PFT, etiology of liver failure, liver function tests, or PASP between patients with and without IPS. 12,18 It was interesting that patients with diabetes were less likely to have IPS.…”

“…Two small studies have reported a prevalence of IPS ranging from 13-47% in patients with hepatic cirrhosis. 5,6 An actuarial decrease in survival among patients with IPS compared with those with no IPS was observed. 6 Intrapulmonary shunting can be associated with hypoxemia, likely related to right-to-left shunting or decrease diffusion across the pulmonary vascular bed.…”

“…5,6 An actuarial decrease in survival among patients with IPS compared with those with no IPS was observed. 6 Intrapulmonary shunting can be associated with hypoxemia, likely related to right-to-left shunting or decrease diffusion across the pulmonary vascular bed. 7 Although many therapies for IPS have been studied, none are currently recommended for routine clinical use.…”

Hepatopulmonary syndrome in pediatric patients (clinical presentation)

“…при от-сутствии кардиореспираторных заболеваний [3]. Распространенность гепатопульмонального син-дрома у больных циррозом печени варьирует от 4 до 47%, причем среди кандидатов на трансплантацию печени этот синдром встречается в 15-20% случа-ев [3,4]. Такой широкий диапазон показателей рас-пространенности синдрома может быть объяснен различными критериями определения артериальной гипоксемии в исследованиях.…”

Transesophageal echocardiography and orthotopic liver transplantation: General concepts

“…16,17 TEE also allows the intraoperative diagnosis of hepatopulmonary syndrome in patients in whom the diagnosis was missed preoperatively. [18][19][20][21] TEE has shown the presence of direct communications between portal vein and pulmonary veins. 22 Finally, TEE allows for the intraoperative evaluation of the major vessels, including the suprahepatic inferior vena cava anastomosis; patients with previous LeVeen shunts may have narrowing or occlusion of the superior vena cava.…”