{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T05:07:00Z","timestamp":1783141620816,"version":"3.54.6"},"reference-count":29,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2020,9,3]],"date-time":"2020-09-03T00:00:00Z","timestamp":1599091200000},"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":["Pediatric Transplantation"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Data on pediatric patients with HPS undergoing LT are limited. Our aim was to study the spectrum and outcomes of pediatric patients with HPS undergoing LDLT. The role ofiNO for post\u2010LDLT refractory hypoxemia was also assessed. Patients (aged\u00a0&lt;\u00a018\u00a0years) undergoing LT were retrospectively studied. HPS was diagnosed based on European Respiratory Society Taskforce 2004 criteria. HPS was graded based on oxygenation criteria and contrast\u2010enhanced echocardiogram. Post\u2010operative course was studied. Refractory post\u2010operative hypoxemia was treated with iNO by institutionally developed protocol. 23\/150 pediatric patients undergoing LDLT had HPS. BA was the most common underlying cause (52.2%). By oxygenation criteria, 6 (26.1%) had VS\u2010HPS. VS\u2010HPS was associated with longer LOS (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.031) and prolonged oxygen requirement (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.001) compared with other HPS patients. 4\/6 patients with VS\u2010HPS had pO2\u00a0&lt;\u00a045\u00a0mm\u00a0Hg. Among these, 2 developed ICH post\u2010operatively and 1 died. 3 developed refractory post\u2010operative hypoxemia, successfully treated with iNO. Mean duration of iNO was 26.3\u00a0days. In the group of patients with HPS, the incidence of HAT and portal vein thrombosis was 17.3% and 4.3%, respectively. One year post\u2010LDLT survival of patients with HPS was similar to non\u2010HPS patients (86.9% vs 94.4%; <jats:italic>p<\/jats:italic>\u00a0=\u00a0.88). We concluded that, pediatric patients with VS\u2010HPS, especially those with pre\u2010operative pO2\u00a0&lt;\u00a045\u00a0mm\u00a0Hg, have long and difficult post\u2010LT course. Refractory postoperative hypoxemia can be successfully overcome with strategic use of iNO. Vigilant monitoring and good intensive care support are essential.<\/jats:p>","DOI":"10.1111\/petr.13792","type":"journal-article","created":{"date-parts":[[2020,9,3]],"date-time":"2020-09-03T13:53:29Z","timestamp":1599141209000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Pediatric liver transplantation in severe hepatopulmonary syndrome and use of inhaled nitric oxide for post\u2010transplant hypoxemia\u2013a single center experience"],"prefix":"10.1111","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3398-1792","authenticated-orcid":false,"given":"Veena","family":"Raghunathan","sequence":"first","affiliation":[{"name":"Department of Pediatric Critical Care Medanta The Medicity Gurgaon India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neelam","family":"Mohan","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology, Hepatology &amp; Liver 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