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Korean J Anesthesiol > Volume 49(4); 2005 > Article
Korean Journal of Anesthesiology 2005;49(4):558-562.
DOI: https://doi.org/10.4097/kjae.2005.49.4.558   
Liver Transplantation and Nitric Oxide Treatment for a Patient with Severe Pulmonary Hypertension: A case report.
Gaab Soo Kim, Soo Jin Kim, Sang Min Lee
Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. marialee@smc.samsung.co.kr
Abstract
A 47-year-old male was admitted for superimposed acute alcoholic hepatitis with underlying alcoholic cirrhosis. His hospital course was complicated with poorly controlled ascites and pneumonia. He was admitted to intensive care unit for ventilator care and transferred to ward. Elective living-related liver transplantation was scheduled. After anesthetic induction, high pulmonary arterial pressures (82/38, mean 58 mmHg) were noticed via Swan-Ganz pulmonary catheter. Transesophageal echocardiography revealed minimal tricuspid and mitral regurgitation, left atrial enlargement, and slight paradoxical septal motion at apex. Surgery was postponed and he was revealed to be sensitive to NO inhalation. His hepatic encephalopathy was aggravated and liver transplantation was rescheduled. Intraoperative NO was delivered and operation was uneventful. Prostaglandin E1 was infused intraoperatively and postoperatively. He was extubated on 4th postoperative day and pulmonary arterial pressures monitoring was discontinued on 7th postoperative day. He was discharged home one month after transplantation without complication.
Key Words: liver transplantation; nitric oxide; pulmonary hypertension
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