Liver transplantation for severe portopulmonary hypertension: A case report and literature review

Table 1 Perioperative managements and pulmonary pressure changes

	Before operation			After operation
	6 mo	4 mo	1 mo	1 mo	3 mo	6 mo	12 mo	14 mo
Remodulin1 (ng/kg/min)	0.8	8.3	16.5	14.4	8.3	6.2	2.0 Withdraw	None
Combined drugs	Furosemide 20 mg qd; Spironolactone 20 mg bid	Tadalafil 30 mg qd	Tadalafil 30 mg qd	None	None	None	None	None
sPAP (mmHg)	81.0 (133 by echocardiography)	79.0	65.0	41.1	37.1	44.5	39.2	37.4
mPAP (mmHg)	50	46	37	Unavailable2
PAWP (mmHg)	20	9	21
PVR (dyn∙s/cm5)	460	470	175

¹Before operation, the dose of Remodulin increased by 0.4125 ng/kg/min every 2 d if there are no unbearable side effects and reduced by 2 ng/kg/min per month after operation if pulmonary artery pressure is decreasing gradually.

²Because right heart catheterization is an invasive procedure, we usually use transthoracic echocardiography to assess pulmonary artery pressure changes after transplantation. Therefore, the mPAP, PAWP and PVR were unavailable. sPAP: Systolic pulmonary artery pressure; mPAP: Mean pulmonary artery pressure; PAWP: Pulmonary artery wedge pressure; PVR: Pulmonary vascular resistance.