Medical Care of the Liver Transplant Patient: Total Pre-, by Paul G Killenberg, Pierre-Alain Clavien

By Paul G Killenberg, Pierre-Alain Clavien

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By Paul G Killenberg, Pierre-Alain Clavien

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Extra resources for Medical Care of the Liver Transplant Patient: Total Pre-, Intra- and Post-Operative Management 3rd ed

Example text

Echocardiography is the screening method of choice [74,75]. Using a systolic right ventricular pressure (RVsys) of more than 50 mmHg as a cutoff, the sensitivity and specificity to detect moderate to severe PPHNT is 97% and 77%, respectively. Only these patients need to undergo right heart catheterization to fully characterize pulmonary hemodynamics. If moderate to severe PPHNT is confirmed, treatment with pulmonary vasodilators should be instituted with the aim of decreasing PAP to <35---40 mmHg and PVR to <400 dyne=s=cm5 [76].

Mandell MS. Hepatopulmonary syndrome and portopulmonary hypertension in the model for end-stage liver disease (MELD) era. Liver Transpl 2004;10(10, suppl 2):S54–S58. 80. Arguedas MR, Abrams GA, Krowka MJ, et al. Prospective evaluation of outcomes and predictors of mortality in patients with hepatopulmonary syndrome undergoing liver transplantation. Hepatology 2003;37(1):192–197. 81. O’Brien JD, Ettinger NA. Pulmonary complications of liver transplantation. Clin Chest Med 1996;17(1):99–114. 82. Abrams GA, Sanders MK, Fallon MB.

Ann Intern Med 1987;107(5):656–664. 41. Rabinovitz M, Yoo YK, Schade RR, et al. Prevalence of endoscopic findings in 510 consecutive individuals with cirrhosis evaluated prospectively. Dig Dis Sci 1990;35(6):705–710. 42. Weller DA, DeGuide JJ, Riegler JL. Utility of endoscopic evaluations in liver transplant candidates. Am J Gastroenterol 1998;93(8):1346–1350. 43. Zaman A, Hapke R, Flora K, et al. Prevalence of upper and lower gastrointestinal tract findings in liver transplant candidates undergoing screening endoscopic evaluation.

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