Article commented Goldberg DS, Krok K, Batra S, Trotter JF, Kawut SM, Fallon MB. Impact of the hepatopulmonary syndrome MELD exception policy on outcomes of patients after liver transplantation: An analysis of the UNOS database. Gastroenterology 2014; 146: 1256-65. Comment Hepatopulmonary syndrome (HPS) represents a serious lung vascular disorder, resulting in significant morbidity and mortality, especially when liver transplantation (LT) is being considered, influencing the pre, trans, and post-LT outcomes. HPS is best characterized by the documentation of impaired oxygenation (widened alveolar-arterial oxygen pressure gradient [PA-aO2] > 15 or > 20 mmHg in patients older than 64 years, with or without concomitant hypoxemia at room air) in the setting of intrapulmonary vascular dilatations (IPVD) confirmed by contrast-enhanced echocardiography or lung perfusion scanning (shunt fraction > 6%) and liver disease or portal hypertension. HPS can occur in the setting of any degree of liver disease, from well-compensated liver cirrhosis with portal hypertension to acute liver failure. The prevalence of HPS ranges from 1-4% in non-LT referral community hospitals up to 32% in patients being evaluated for LT. Perhaps such a differing prevalence can be attributed to the wide heterogeneity of the applied diagnostic criteria.
2014-07-07 | 375 visitas | Evalua este artículo 0 valoraciones
Vol. 13 Núm.4. Julio-Agosto 2014 Pags. 468-470 Ann Hepatol 2014; 13(4)