Cerebrovascular Accidents After Orthotopic Liver Transplantation in Patients with Hepatopulmonary Syndrome: A Case Series
<b>Background:</b> Hepatopulmonary syndrome (HPS), defined by the presence of pulmonary vascular dilatations that cause right-to-left transpulmonary shunting of venous blood with a consequential increase in the alveolar–arterial oxygen gradient, is a relatively frequent complication of c...
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MDPI AG
2024-12-01
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| Online Access: | https://www.mdpi.com/2039-7283/15/1/5 |
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| author | Steffi K. Chan Manuel M. Buitrago Blanco Nicholas J. Feduska Vatche G. Agopian Samer S. Ebaid Tisha Wang Ami Tamhaney Igor Barjaktarevic |
| author_facet | Steffi K. Chan Manuel M. Buitrago Blanco Nicholas J. Feduska Vatche G. Agopian Samer S. Ebaid Tisha Wang Ami Tamhaney Igor Barjaktarevic |
| author_sort | Steffi K. Chan |
| collection | DOAJ |
| description | <b>Background:</b> Hepatopulmonary syndrome (HPS), defined by the presence of pulmonary vascular dilatations that cause right-to-left transpulmonary shunting of venous blood with a consequential increase in the alveolar–arterial oxygen gradient, is a relatively frequent complication of chronic liver disease. While orthotopic liver transplantation (OLT) is indicated and often curative in HPS patients with end-stage liver disease (ESLD), little is known about the peri- and post-operative-period risks of CVA in OLT recipients with HPS. <b>Case Presentation</b>: We report a case series of five non-consecutive OLT recipients with HPS who developed ischemic and/or hemorrhagic CVAs during or shortly after OLT, raising concern that the risks of neurological complications remain increased even after OLT. <b>Conclusions:</b> Our case series hopes to highlight the importance of close vigilance in this subset of patients, at a time when there may be multiple issues to be addressed in facilitating post-operative recovery. |
| format | Article |
| id | doaj-art-c763116c489041099bca26d3bd64c077 |
| institution | Kabale University |
| issn | 2039-7283 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Clinics and Practice |
| spelling | doaj-art-c763116c489041099bca26d3bd64c0772025-01-24T13:27:39ZengMDPI AGClinics and Practice2039-72832024-12-01151510.3390/clinpract15010005Cerebrovascular Accidents After Orthotopic Liver Transplantation in Patients with Hepatopulmonary Syndrome: A Case SeriesSteffi K. Chan0Manuel M. Buitrago Blanco1Nicholas J. Feduska2Vatche G. Agopian3Samer S. Ebaid4Tisha Wang5Ami Tamhaney6Igor Barjaktarevic7Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USADivision of Neurocritical Care, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USADivision of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USADivision of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USADivision of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USADivision of Pulmonary and Critical Care Medicine, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USADavid Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USADivision of Pulmonary and Critical Care Medicine, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA<b>Background:</b> Hepatopulmonary syndrome (HPS), defined by the presence of pulmonary vascular dilatations that cause right-to-left transpulmonary shunting of venous blood with a consequential increase in the alveolar–arterial oxygen gradient, is a relatively frequent complication of chronic liver disease. While orthotopic liver transplantation (OLT) is indicated and often curative in HPS patients with end-stage liver disease (ESLD), little is known about the peri- and post-operative-period risks of CVA in OLT recipients with HPS. <b>Case Presentation</b>: We report a case series of five non-consecutive OLT recipients with HPS who developed ischemic and/or hemorrhagic CVAs during or shortly after OLT, raising concern that the risks of neurological complications remain increased even after OLT. <b>Conclusions:</b> Our case series hopes to highlight the importance of close vigilance in this subset of patients, at a time when there may be multiple issues to be addressed in facilitating post-operative recovery.https://www.mdpi.com/2039-7283/15/1/5hepatopulmonary syndromeorthotopic liver transplantend-stage liver diseasecerebrovascular accidentstroke |
| spellingShingle | Steffi K. Chan Manuel M. Buitrago Blanco Nicholas J. Feduska Vatche G. Agopian Samer S. Ebaid Tisha Wang Ami Tamhaney Igor Barjaktarevic Cerebrovascular Accidents After Orthotopic Liver Transplantation in Patients with Hepatopulmonary Syndrome: A Case Series Clinics and Practice hepatopulmonary syndrome orthotopic liver transplant end-stage liver disease cerebrovascular accident stroke |
| title | Cerebrovascular Accidents After Orthotopic Liver Transplantation in Patients with Hepatopulmonary Syndrome: A Case Series |
| title_full | Cerebrovascular Accidents After Orthotopic Liver Transplantation in Patients with Hepatopulmonary Syndrome: A Case Series |
| title_fullStr | Cerebrovascular Accidents After Orthotopic Liver Transplantation in Patients with Hepatopulmonary Syndrome: A Case Series |
| title_full_unstemmed | Cerebrovascular Accidents After Orthotopic Liver Transplantation in Patients with Hepatopulmonary Syndrome: A Case Series |
| title_short | Cerebrovascular Accidents After Orthotopic Liver Transplantation in Patients with Hepatopulmonary Syndrome: A Case Series |
| title_sort | cerebrovascular accidents after orthotopic liver transplantation in patients with hepatopulmonary syndrome a case series |
| topic | hepatopulmonary syndrome orthotopic liver transplant end-stage liver disease cerebrovascular accident stroke |
| url | https://www.mdpi.com/2039-7283/15/1/5 |
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