Liver transplantation for hepatopulmonary and sinusoidal obstruction syndrome

Introduction - The hepatopulmonary syndrome is a complication of liver diseases that affects the pulmonary vascular system compromising respiratory function. High morbidity rates are associated with this syndrome. Liver transplantation is the treatment of choice. The aim of this report is to present the case of a patient who sustained advanced hepatopulmonary syndrome resulting from the sinusoidal obstruction syndrome. Case report-A23-year-old male was referred with the diagnosis of advanced hepatopulmonary syndrome and liver cirrhosis of undefined etiology. Imaging studies were consistent with intrapulmonary shunt yet without alterations in pulmonary vascularization amenable to embolization. Upper digestive endoscopy demonstrated small-caliber esophagian varices. Laboratory tests for liver function showed alterations. The patient underwent liver transplantation and died 14 days after, due tosepsis-related complications and refractory ventilatory failure. Conclusion - In cases when it is not feasible to perform selective embolization in the shunt area, the only effective treatment for hepatopulmonary syndrome is liver transplantation.