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A 48-year-old woman developed deterioration of pulmonary hypertension (PHT), liver function and kidney function during treatment with terlipressin [indication, dosage and duration of treatment to reactions onset not stated].
The woman was scheduled for urgent orthotopic liver transplantation (OLT) following an acute on chronic deterioration in liver function on a background of non-alcoholic steato-hepatitis (NASH), Caroli's disease and possible haemochromatosis. She had a significant history of portal hypertension with ascites, oesophageal varices and encephalopathy. Echocardiography performed 18 months before the scheduled transplantation showed normal left and right ventricular (RV) systolic function and trivial tricuspid regurgitation (TR). Pulmonary arterial pressure (PAP) was deemed to be decreased but could not be estimated because of the minimal TR jet. Therefore, a right heart catheterisation study was not performed. Her Model for End-Stage Liver Disease (MELD) score was found...
- Pearce B, et al. Intraoperative TOE guided management of newly diagnosed severe tricuspid regurgitation and pulmonary hypertension during orthotopic liver transplantation: A case report demonstrating the importance of reversibility as a favorable prognostic factor. BMC Anesthesiology 19: No. 1, 13 Jul 2019. Available from: URL: http://doi.org/10.1186/s12871-019-0795-6 - Australia