ReviewAmerican journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons2015
Proposed management algorithm for severe hypoxemia after liver transplantation in the hepatopulmonary syndrome.
Review in American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 66 citations in OpenAlex.
- Management of postoperative hypoxemia in pediatric patients with hepatopulmonary syndrome through ventilatory support strategies: a report of three casesRevista de la Facultad de Ciencias Medicas (Cordoba, Argentina) · 2026Observational
- SerpinB1a induces hepatopulmonary syndrome by promoting CTSG/AMPK/mTOR pathway-mediated mitophagy.Cell biology and toxicology · 2025Article
- Improvement in oxygenation with a calcium channel blocker in a patient with hepatopulmonary syndrome during tacrolimus therapy following living donor liver transplantation - A case report.Indian journal of anaesthesia · 2024Article
- Inhaled nitric oxide as a salvage therapy for refractory hypoxemia in the post-transplantation period of hepatopulmonary syndrome: An explorative report of three cases.Liver research (Beijing, China) · 2024Article
- Navigating a complicated liver transplant in a patient with severe hepatopulmonary syndrome without extracorporeal membrane oxygenation: a case report.Singapore medical journal · 2023Article
- Quercetin ameliorates acute lung injury in a rat model of hepatopulmonary syndrome.BMC complementary medicine and therapies · 2022Article
- The Edge of Unknown: Postoperative Critical Care in Liver Transplantation.Journal of clinical medicine · 2022Review
- Excellent outcomes with liver transplantation in hepatopulmonary syndrome across pre-transplant PaOJHEP reports : innovation in hepatology · 2021Article
- Hepatopulmonary Syndrome and Portopulmonary Hypertension: Current Status and Implications for Liver Transplantation.Current hepatology reports · 2020Article
- Potential Clinical Targets in Hepatopulmonary Syndrome: Lessons From Experimental Models.Hepatology (Baltimore, Md.) · 2018Review
- Differential diagnosis of hepatopulmonary syndrome (HPS): Portopulmonary hypertension (PPH) and hereditary hemorrhagic telangiectasia (HHT).Bosnian journal of basic medical sciences · 2017Review
- Extracorporeal membrane oxygenation for post-transplant hypoxaemia following very severe hepatopulmonary syndrome.BMJ case reports · 2017Article
- Approach to the liver transplant early postoperative period: an institutional standpoint.Revista Brasileira de terapia intensivaReview
- Pulmonary Assessment of the Liver Transplant Recipient.Journal of clinical and experimental hepatologyReview
- The Canadian Hepatopulmonary Syndrome Program: A Longitudinal Liver Transplant Experience.Journal of clinical and experimental hepatologyArticle
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The hepatopulmonary syndrome (HPS) is defined as the triad of liver disease, intrapulmonary vascular dilatation, and abnormal gas exchange, and is found in 10-32% of patients with liver disease. Liver transplantation is the only known cure for HPS, but patients can develop severe posttransplant hypoxemia, defined as a need for 100% inspired oxygen to maintain a saturation of ≥85%. This complication is seen in 6-21% of patients and carries a 45% mortality. Its management requires the application of specific strategies targeting the underlying physiologic abnormalities in HPS, but awareness of these strategies and knowledge on their optimal use is limited. We reviewed existing literature to identify strategies that can be used for this complication, and developed a clinical management algorithm based on best evidence and expert opinion. Evidence was limited to case reports and case series, and we determined which treatments to include in the algorithm and their recommended sequence based on their relative likelihood of success, invasiveness, and risk. Recommended therapies include: Trendelenburg positioning, inhaled epoprostenol or nitric oxide, methylene blue, embolization of abnormal pulmonary vessels, and extracorporeal life support. Availability and use of this pragmatic algorithm may improve management of this complication, and will benefit from prospective validation.
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