{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T06:53:19Z","timestamp":1769151199804,"version":"3.49.0"},"reference-count":18,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2019,6,10]],"date-time":"2019-06-10T00:00:00Z","timestamp":1560124800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Hepato Biliary Pancreat"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Hepatopulmonary syndrome (<jats:styled-content style=\"fixed-case\">HPS<\/jats:styled-content>) negatively affects the outcomes of deceased donor liver transplantation (<jats:styled-content style=\"fixed-case\">LT<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively reviewed the clinical records of patients with <jats:styled-content style=\"fixed-case\">HPS<\/jats:styled-content> who underwent <jats:styled-content style=\"fixed-case\">LT<\/jats:styled-content> and studied the impact of risk factors on clinical outcomes to determine strategies to overcome complications. Patients with symptoms of hypo\u2010oxygenemia and a shunt ratio &gt;15% on 99mTc\u2010<jats:styled-content style=\"fixed-case\">MAA<\/jats:styled-content> lung perfusion scintigraphy were defined as having <jats:styled-content style=\"fixed-case\">HPS<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010eight patients in 10 centers were enrolled. Diseases included biliary atresia, liver cirrhosis, non\u2010alcoholic steatohepatitis, congenital hepatic fibrosis, and others. The length of <jats:styled-content style=\"fixed-case\">ICU<\/jats:styled-content> stay was 2\u2013170\u00a0days. The respirator was used for 41.6% of patients on post\u2010operative day (POD) 3 and 20.8% on <jats:styled-content style=\"fixed-case\">POD<\/jats:styled-content> 14. The patient survival rate was 87% at 1\u00a0year and 82% at 5\u00a0years. The causes of hospital mortality were sepsis, thrombotic microangiopathy, intracranial bleeding, pulmonary fibrosis, and transplant rejection. An amount of shunt ratio prior to <jats:styled-content style=\"fixed-case\">LT<\/jats:styled-content> was a significant risk factor for hospital mortality. Hypoxia from <jats:styled-content style=\"fixed-case\">POD<\/jats:styled-content> 3 to <jats:styled-content style=\"fixed-case\">POD<\/jats:styled-content> 14 was a risk factor for biliary stenosis. The shunt ratio of all surviving patients significantly improved.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Although <jats:styled-content style=\"fixed-case\">LT<\/jats:styled-content> is feasible for patients with <jats:styled-content style=\"fixed-case\">HPS<\/jats:styled-content>, early transplantation and avoiding hypo\u2010oxygenemia immediately after transplantation are important.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jhbp.632","type":"journal-article","created":{"date-parts":[[2019,5,9]],"date-time":"2019-05-09T06:44:57Z","timestamp":1557384297000},"page":"292-299","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Current status of hepatopulmonary syndrome in liver transplantation in Japan: a Japanese multicenter analysis"],"prefix":"10.1002","volume":"26","author":[{"given":"Yoshihito","family":"Kotera","sequence":"first","affiliation":[{"name":"Department of Surgery Institute of Gastroenterology Tokyo Women's Medical University Shinjuku Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroto","family":"Egawa","sequence":"additional","affiliation":[{"name":"Department of Surgery Institute of Gastroenterology Tokyo Women's Medical University Shinjuku Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoshi","family":"Ogata","sequence":"additional","affiliation":[{"name":"Department of Surgery Institute of Gastroenterology Tokyo Women's Medical University Shinjuku Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoshi","family":"Teramukai","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshimi","family":"Kaido","sequence":"additional","affiliation":[{"name":"Division of Hepato\u2010Biliary\u2010Pancreatic Surgery and Transplantation Kyoto University Graduate School of Medicine Kyoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ken","family":"Shirabe","sequence":"additional","affiliation":[{"name":"Division of Hepato\u2010Biliary\u2010Pancreatic Surgery and Transplantation Gunma University Graduate School of Medicine Gunma Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akinobu","family":"Taketomi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery I Hokkaido University Graduate School of Medicine Hokkaido Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasutugu","family":"Takada","sequence":"additional","affiliation":[{"name":"Department of Hepato\u2010Biliary\u2010Pancreatic and Breast Surgery Ehime University Graduate School of Medicine Ehime Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masakazu","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Surgery Institute of Gastroenterology Tokyo Women's Medical University Shinjuku Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroki","family":"Yamaue","sequence":"additional","affiliation":[{"name":"Second Department of Surgery Wakayama Medical University Wakayama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"the Japanese Society of Hepato\u2010Biliary\u2010Pancreatic Surgery","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,6,10]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"133","article-title":"Prevalence and reversibility of the hepatopulmonary syndrome after liver transplantation. 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