Andrius Macas, Limas Kupčinskas, Giedrius Barauskas, Darius Trepenaitis, Juozas Kupčinskas, Aurelija Petkevičiūtė, Asta Mačiulienė
Portopulmonary hypertension is one of the complications for people with end stage chronic liver disease. This condition occurs to 5-8% of people, who need liver transplantation, and it causes a higher risk of perioperative complications or these patients are even banned from this procedure. Therefore, it is very important to diagnose this pathology in time using right heart catheterization and provocative volume and dobutamine samples for evaluation of the right ventricle function. Fortunately, adequate medical treatment with its most important part – vasodilator drugs – cures portopulmonary hypertension or lowers the perioperative risk caused by this condition.
This case report presents a 50-year-old male hospitalized for liver transplantation. The patient has cirrhosis of the liver caused by hepatitis C, liver failure and portopulmonary hypertension. He has been taking vasodilator drugs for almost 8 months in order to prepare for a surgical treatment and when the operation’s day came, all tests needed including echocardiography shown that the transplantation could be performed. During the operation patient’s heart function was monitored with transesophageal echocardiography. Even though the mean pulmonary arterial pressure was marginal, the operation was successful and the patient could be extubated right after the procedure. Systolic pulmonary arterial pressure of the recipient dropped from 70 mmHg to 60.
Keyword(s): pulmonary hypertension; portopulmonary hypertension; liver transplantation
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