Screening of Hepatopulmonary Syndrome (HPS) with CEUS and Pulse-Oximetry in Liver Cirrhosis Patients Eligible for Liver Transplant
A.I. Suceveanu, L. Mazilu, D. Tomescu, N. Ciufu, I.R. Parepa, A.P. SuceveanuOriginal article, no. 5, 2013
Background and aim: The prevalence of hepatopulmonarysyndrome (HPS) in the setting of cirrhosis ranges between4%-47%. We aimed to detect a correlation between heartand lungs findings on contrast-enhanced ultrasound (CEUS)and pulse-oximetry, in order to early detect HPS and thus toimprove patients referral to orthotopic liver transplantation(OLT).Methods: We considered at risk for HPS all patients withdelayed left ventricle (LV) enhancement of the contrast agent,at least 3 systolic beats after it appears in the right ventricle(RV). We correlated CEUS results with pulse-oximetry findings,considering to have a positive HPS diagnosis in all patientswith both CEUS findings and SaO2 95%.Results: From 186 patients diagnosed with liver cirrhosis, 56patients (30.10%) had delayed LV enhancement of the contrastagent. Pulse-oximetry showed alterations, such as SaO2 95%and PaO2 70 mmHg in 62 patients (33.33%). Pearson indexshowed a good correlation between lung and heart CEUSfindings and pulse-oximetry (r=0.99) in HPS diagnosis.Conclusions. Two non-invasive, simple and rapid methods suchas CEUS and pulse-oximetry can easily diagnose HPS, ahighly fatal complication of liver cirrhosis, and can also guidethe future treatment by speeding up OLT recommendations.
