Effect of transjugular intrahepatic portosystemic shunt on pulmonary gas exchange in patients with portal hypertension and hepatopulmonary syndrome

Table 1 Demographic and clinical characteristics (mean±SD, n)

	HPS (n = 3)	Non-HPS (n = 4)
Sex (M/F)	2/1	4/–
Age (yr)	50±22	48±10
Smoking (n)	1	4
Current	-	2
Past	1	2
Etiology of chronic liver disease (n)
Hepatitis C	1	1
Alcohol abuse	1	3
Idiopathic portal hypertension	1
Child–Pugh score A/B/C (n)	1/2/–	1/2/1
Presence of esophageal varices	3	4
Gastrointestinal bleeding	2	3
Ascites	1	1
Hepatic encephalopathy	–	–
Cutaneous spider nevi	3	3
Concomitant respiratory symptoms
Digital clubbing	3	–
Dyspnea	3	1
Cyanosis	3	–
Indication of TIPS
Variceal bleeding	–	3
Refractory ascites	–	1
Hepatopulmonary syndrome	3	–

TIPS: transjugular intrahepatic portosystemic shunt；Query: please check the change made.

Table 2 Pulmonary gas exchange before and after TIPS placement in patients without HPS (mean±SD)

	Pre-TIPS	Post-TIPS
PaO2 (mmHg)	95±16	95±27
PaCO2 (mmHg)	29±6	31±7
AaPO2 (mmHg)	18±12	18±20
FEV1 (% pred)	72±9	74±5
FVC (% pred)	76±6	80±2
FEV1/FVC	75±10	76±8
DLCO (mL/(min×mmHg))	22±4	20±5
DLCO (% pred)	67±13	63±9

PaO₂: partial pressure of arterial oxygen; PaCO₂: partial pressure of arterial carbon dioxide; AaPO₂: alveolar to arterial oxygen partial pressure gradient; FEV1: forced expiratory volume at 1 s; FVC: forced vital capacity; FEV1/FVC: ratio of forced expiratory volume at 1 s to forced vital capacity; DL_CO: single-breath carbon monoxide diffusing capacity.

Table 3 Pulmonary gas exchange and hemodynamics before and after TIPS placement in patients with HPS

	Pre-TIPS			Post-TIPS <1 mo			Post-TIPS >4 mo
Patients	# 1	# 2	# 3	# 1	# 2	# 3	# 1	# 2	# 3
FEV1 (% pred)	69	77	100
FVC (% pred)	66	77	113
FEV1/FVC	77	80	82
TLC (% pred)	68	70	83
DLCO (% pred)	21.3	24	8
PaO2 (mmHg)	32	59	28	58	61	31	33	34	–
PaCO2 (mmHg)	27	28	35	31	27	38	26	34	–
AaPO2 (mmHg)	88	54	78	53	69	71	87	73	–
PaO2 100% O2 breathing (mmHg)	64	606	86	–	–	–	–	–	–
PAP (mmHg)	14.5	9	18	–	8	22	20	8	–
PVR (dyn.s/cm5)	49	31	111	–	21	82	38	18	–
SVR (dyn.s/cm5)	773	415	1 174	–	400	922	549	560	–
QT (L/min)	9.0	10.4	6.47	–	11.2	7.8	10.5	11.3	–
PP (mmHg)	22	16	19	14	11	22	18.5	11	–
IVCP (mmHg)	5	4	3	7	2.5	19	8	2.5	–
PPG (mmHg)	17	12	16	7	8.5	3	10.5	8.5	–

FEV₁: forced expiratory volume at 1 s; FVC: forced vital capacity; TLC: total lung capacity; DL_CO: single-breath carbon monoxide diffusing capacity; PaO₂: partial pressure of arterial oxygen; PaCO₂: partial pressure of arterial carbon dioxide; AaPO₂: alveolar to arterial oxygen partial pressure gradient; PAP: mean pulmonary artery pressure; PVR: pulmonary vascular resistance; SVR: systemic vascular resistance; Q_T: cardiac output; PP: portal pressure; IVCP: inferior vena cava pressure; PPG: portocaval pressure gradient.