Intrapulmonary shunting in biliary atresia before and after living-relatedliver transplantation

Citation
T. Yonemura et al., Intrapulmonary shunting in biliary atresia before and after living-relatedliver transplantation, BR J SURG, 86(9), 1999, pp. 1139-1143
Citations number
14
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Surgery,"Medical Research Diagnosis & Treatment
Journal title
BRITISH JOURNAL OF SURGERY
ISSN journal
0007-1323 → ACNP
Volume
86
Issue
9
Year of publication
1999
Pages
1139 - 1143
Database
ISI
SICI code
0007-1323(199909)86:9<1139:ISIBAB>2.0.ZU;2-3
Abstract
Background: Intrapulmonary shunting (IPS) is frequently observed and causes hypoxaemia in liver cirrhosis. This study investigated the prevalence, pre dictors of reversibility and the effect of living-related liver transplanta tion (LRLT) on IPS using contrast echocardiography in patients with end-sta ge biliary atresia. Methods: Fifty consecutive patients with biliary atresia were examined for IPS using contrast echocardiography before and after LRLT until IPS disappe ared. The severity of IPS was classified into five grades according to the extent of contrast in the left ventricle (0, none; 1, trivial; 2, apparent; 3, complete but less than in right ventricle; 4, as dense as in right vent ricle). Results: Thirty-two patients (grade 1, n = 15; grade 2, n = 7; grade 3, n = 4; grade 4, n = 6) had IPS before LRLT. Forty-four patients have survived for 9-26 months after LRLT. Among patients with grade 3 or 4 IPS (n = 8), t here was a significant correlation between age at LRLT and the duration of IPS persistence after LRLT (P = 0.044). Conclusion: IPS takes longer to disappear in older children than in younger ones, but always disappears eventually. LRLT is an effective treatment for biliary atresia with IPS.