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Transjugular Intrahepatic Portosystemic Shunt: A Successful Treatment for Hepatopulmonary Syndrome

Selim, Khaled M, MD; Akriviadis, Evangelos A, MD; Zuckerman, Eli, MD; Chen, David, MD; Reynolds, Telfer B, MD*

American Journal of Gastroenterology: March 1998 - Volume 93 - Issue 3 - p 455–458
doi: 10.1111/j.1572-0241.1998.00455.x

Hepatopulmonary syndrome is a well described complication of chronic liver disease. Though uncommon, it carries a high morbidity and mortality. The pathogenesis of the syndrome has not been clearly defined. Portal hypertension seems to play a crucial role in the pathogenesis of the syndrome, probably by enhancing nitric oxide production. As yet, no pharmacological therapy has been proven effective. Many reports of successful reversal of the syndrome after liver transplantation have been published. We report a patient with hepatopulmonary syndrome who showed a significant and durable (4 months’) improvement in his symptoms, arterial oxygenation, and intrapulmonary shunts, as calculated by radionuclide studies after transjugular intrahepatic portosystemic shunt placement. Transjugular intrahepatic portosystemic shunt may represent a durable treatment option for patients with hepatopulmonary syndrome.

The University of Southern California Liver Unit and Department of Nuclear Medicine, Rancho Los Amigos Medical Center Downey, California

*Loosli-Hastings Foundation Professor of Medicine, Division of Gastrointestinal and Liver Diseases, University of Southern California School of Medicine, 2025 Zonal Ave. (GNH 12-137), Los Angeles, CA 90033.

© The American College of Gastroenterology 1998. All Rights Reserved.
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