Pulmonary contraindications, indications and MELD exceptions for liver transplantation: A contemporary view and look forward

Michael J. Krowka, Russell H. Wiesner, Julie K. Heimbach

Research output: Contribution to journalReview articlepeer-review

65 Scopus citations

Abstract

Summary Pulmonary concerns in liver transplant candidates have intraoperative and outcome implications. Evolving MELD exception policies address transplant priority for problems such as hepatopulmonary syndrome, portopulmonary hypertension, and hemorrhagic hereditary telangiectasia. Other pulmonary issues such as refractory hepatic hydrothorax, advanced chronic obstructive lung disease (including alpha-1 antitrypsin deficiency) and indeterminate pulmonary nodules may affect liver transplant consideration. Herein, we discuss current pulmonary-related contraindications, indications and MELD exception policies for liver transplantation, suggesting future considerations.

Original languageEnglish (US)
Pages (from-to)367-374
Number of pages8
JournalJournal of hepatology
Volume59
Issue number2
DOIs
StatePublished - Aug 2013

Keywords

  • Alpha-1 antitrypsin deficiency
  • Hepatic hydrothorax
  • Hepatopulmonary syndrome
  • Hereditary hemorrhagic telangiectasia
  • Portopulmonary hypertension
  • Pulmonary nodules

ASJC Scopus subject areas

  • Hepatology

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