Inhaled iloprost for hepatopulmonary syndrome: improvement of hypoxemia

• Published in: European journal of gastroenterology & hepatology Vol. 19; no. 12; p. 1140
• Main Authors: Krug, Sabine, Seyfarth, Hans-Juergen, Hagendorff, Andreas, Wirtz, Hubert
• Format: Journal Article
• Language: English
• Published: England 01.12.2007
• Subjects: Administration, Inhalation; Female; Hepatopulmonary Syndrome - drug therapy; Hepatopulmonary Syndrome - surgery; Humans; Hypoxia - drug therapy; Iloprost - administration & dosage; Liver Transplantation; Middle Aged; Oxygen - blood; Partial Pressure; Postoperative Care - methods; Vasodilator Agents - administration & dosage
• ISSN: 0954-691X
• DOI: 10.1097/MEG.0b013e328220ed72

Hepatopulmonary syndrome is characterized by advanced liver disease, hypoxemia, and intrapulmonary shunting. The only reported curative option is orthotopic liver transplantation. We describe here a beneficial effect of inhaled prostacyclin including a decrease in respiratory symptoms and improved oxygenation in this clinical situation, with no approved pharmacological long-term therapy. The prostanoid iloprost, approved for pulmonary and portopulmonary hypertension, caused an increase in oxygenation, relief of dyspnea, and increased exercise tolerance in a patient suffering from liver-cirrhosis-associated hepatopulmonary syndrome. After liver transplantation, restitution of hepatopulmonary syndrome did not occur immediately. Inhaling iloprost resulted in improved physical condition and better clinical rehabilitation potential until hypoxemia finally resolved 3 months after transplantation. Therefore, iloprost could improve quality of life in patients with hepatopulmonary syndrome waiting for liver transplantation and post surgery until the resolution of the hypoxemia.