iloprost and Alcoholism

Portopulmonary hypertension (PPHTN) is associated with poor prognosis and high perioperative mortality after orthotopic liver transplantation. This study documents the first case of a patient with PPHTN who was successfully bridged to orthotopic liver transplantation with i.v. iloprost, a stable prostacyclin analogue. The PPHTN had resolved completely 4 months after successful transplantation. In conclusion, portopulmonary hypertension is a relative contraindication to orthotopic liver transplantation, which should be attempted only if pulmonary haemodynamics improve with prostanoids. In this context, iloprost may be a valuable alternative to epoprostenol.

Topics: Alcoholism; Carcinoma, Hepatocellular; Hepatitis C, Chronic; Humans; Hypertension, Portal; Hypertension, Pulmonary; Iloprost; Infusions, Intravenous; Liver Cirrhosis; Liver Neoplasms; Liver Transplantation; Middle Aged; Preoperative Care; Vasodilator Agents