Pulmonary vascular morphological changes in cirrhotic patients undergoing liver transplantation
Cirrhosis and portal hypertension may be associated with pulmonary hypertension and pulmonary dysfunction. However, morphological pulmonary vascular lesions in patients with cirrhosis have not been well characterized morphometrically. We morphometrically evaluated pulmonary vessels in liver transpla...
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| Veröffentlicht in: | Liver Transplantation and Surgery 1999-01, Vol.5 (1), p.57-64 |
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| container_title | Liver Transplantation and Surgery |
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| creator | Lamps, Laura W. Carson, Kelly Bradley, Anne L. Pinson, C. Wright Johnson, Joyce E. Coogan, Alice C. Hunter, Ellen B. Clavien, Pierre A. Washington, Mary Kay |
| description | Cirrhosis and portal hypertension may be associated with pulmonary hypertension and pulmonary dysfunction. However, morphological pulmonary vascular lesions in patients with cirrhosis have not been well characterized morphometrically. We morphometrically evaluated pulmonary vessels in liver transplant recipients with pretransplantation cirrhosis and correlated our findings with pretransplantation cardiopulmonary function, postoperative course, and postmortem cardiopulmonary findings. Autopsy lung slides from 23 transplant recipients with pretransplantation cirrhosis were examined. External vessel diameter, intimal thickness, and arterial medial thickness were measured with a micrometer after pentachrome staining. The percent of total diameter comprised by intima or media was calculated for each vessel. Medical records were reviewed for smoking history, pretransplantation cardiopulmonary function testing, and postoperative course. Autopsy cases without liver or significant cardiopulmonary diseases, matched for age, sex, and smoking history, served as controls. Transplant recipients had significantly more pulmonary venous intimal thickening than matched controls (P |
| doi_str_mv | 10.1002/lt.500050110 |
| format | Article |
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Wright ; Johnson, Joyce E. ; Coogan, Alice C. ; Hunter, Ellen B. ; Clavien, Pierre A. ; Washington, Mary Kay</creator><creatorcontrib>Lamps, Laura W. ; Carson, Kelly ; Bradley, Anne L. ; Pinson, C. Wright ; Johnson, Joyce E. ; Coogan, Alice C. ; Hunter, Ellen B. ; Clavien, Pierre A. ; Washington, Mary Kay</creatorcontrib><description>Cirrhosis and portal hypertension may be associated with pulmonary hypertension and pulmonary dysfunction. However, morphological pulmonary vascular lesions in patients with cirrhosis have not been well characterized morphometrically. We morphometrically evaluated pulmonary vessels in liver transplant recipients with pretransplantation cirrhosis and correlated our findings with pretransplantation cardiopulmonary function, postoperative course, and postmortem cardiopulmonary findings. Autopsy lung slides from 23 transplant recipients with pretransplantation cirrhosis were examined. External vessel diameter, intimal thickness, and arterial medial thickness were measured with a micrometer after pentachrome staining. The percent of total diameter comprised by intima or media was calculated for each vessel. Medical records were reviewed for smoking history, pretransplantation cardiopulmonary function testing, and postoperative course. Autopsy cases without liver or significant cardiopulmonary diseases, matched for age, sex, and smoking history, served as controls. Transplant recipients had significantly more pulmonary venous intimal thickening than matched controls (P < .0001). Sixty‐five percent (15 of 23) of these patients had some degree of pretransplantation pulmonary dysfunction, defined by abnormalities in pulmonary function tests, oxygen saturation, and/or increased pulmonary artery pressures. However, the severity of venous intimal thickening did not correlate with the severity of pretransplantation pulmonary dysfunction. Arterial intimal and medial thickness were not statistically significantly different from controls. Pulmonary venous intimal thickening and resultant luminal impingement are morphological findings not previously described in this population. The arterial lesion, when present, is similar to that seen in pulmonary hypertension from other causes. These pulmonary vascular lesions may be implicated in pulmonary dysfunction in patients with cirrhosis and may be associated with increased posttransplantation cardiopulmonary morbidity and mortality.</description><identifier>ISSN: 1074-3022</identifier><identifier>EISSN: 1527-6473</identifier><identifier>DOI: 10.1002/lt.500050110</identifier><identifier>PMID: 9873094</identifier><language>eng</language><publisher>Philadelphia, PA: W.B. Saunders</publisher><subject>Adult ; Female ; Humans ; Hypertension, Portal - pathology ; Hypertension, Portal - surgery ; Liver Cirrhosis - pathology ; Liver Cirrhosis - surgery ; Liver Transplantation ; Lung - pathology ; Male ; Middle Aged ; Myocardium - pathology ; Pulmonary Artery - pathology ; Pulmonary Veins - pathology ; Retrospective Studies ; Tunica Intima - pathology</subject><ispartof>Liver Transplantation and Surgery, 1999-01, Vol.5 (1), p.57-64</ispartof><rights>Copyright © 1999 American Association for the Study of Liver Diseases</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4360-d2ca527395e46a1f817e1c366cfde067ddf5f3d99d6158aefb8a68e8a469854f3</citedby><cites>FETCH-LOGICAL-c4360-d2ca527395e46a1f817e1c366cfde067ddf5f3d99d6158aefb8a68e8a469854f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Flt.500050110$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Flt.500050110$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9873094$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lamps, Laura W.</creatorcontrib><creatorcontrib>Carson, Kelly</creatorcontrib><creatorcontrib>Bradley, Anne L.</creatorcontrib><creatorcontrib>Pinson, C. Wright</creatorcontrib><creatorcontrib>Johnson, Joyce E.</creatorcontrib><creatorcontrib>Coogan, Alice C.</creatorcontrib><creatorcontrib>Hunter, Ellen B.</creatorcontrib><creatorcontrib>Clavien, Pierre A.</creatorcontrib><creatorcontrib>Washington, Mary Kay</creatorcontrib><title>Pulmonary vascular morphological changes in cirrhotic patients undergoing liver transplantation</title><title>Liver Transplantation and Surgery</title><addtitle>Liver Transpl Surg</addtitle><description>Cirrhosis and portal hypertension may be associated with pulmonary hypertension and pulmonary dysfunction. However, morphological pulmonary vascular lesions in patients with cirrhosis have not been well characterized morphometrically. We morphometrically evaluated pulmonary vessels in liver transplant recipients with pretransplantation cirrhosis and correlated our findings with pretransplantation cardiopulmonary function, postoperative course, and postmortem cardiopulmonary findings. Autopsy lung slides from 23 transplant recipients with pretransplantation cirrhosis were examined. External vessel diameter, intimal thickness, and arterial medial thickness were measured with a micrometer after pentachrome staining. The percent of total diameter comprised by intima or media was calculated for each vessel. Medical records were reviewed for smoking history, pretransplantation cardiopulmonary function testing, and postoperative course. Autopsy cases without liver or significant cardiopulmonary diseases, matched for age, sex, and smoking history, served as controls. Transplant recipients had significantly more pulmonary venous intimal thickening than matched controls (P < .0001). Sixty‐five percent (15 of 23) of these patients had some degree of pretransplantation pulmonary dysfunction, defined by abnormalities in pulmonary function tests, oxygen saturation, and/or increased pulmonary artery pressures. However, the severity of venous intimal thickening did not correlate with the severity of pretransplantation pulmonary dysfunction. Arterial intimal and medial thickness were not statistically significantly different from controls. Pulmonary venous intimal thickening and resultant luminal impingement are morphological findings not previously described in this population. The arterial lesion, when present, is similar to that seen in pulmonary hypertension from other causes. These pulmonary vascular lesions may be implicated in pulmonary dysfunction in patients with cirrhosis and may be associated with increased posttransplantation cardiopulmonary morbidity and mortality.</description><subject>Adult</subject><subject>Female</subject><subject>Humans</subject><subject>Hypertension, Portal - pathology</subject><subject>Hypertension, Portal - surgery</subject><subject>Liver Cirrhosis - pathology</subject><subject>Liver Cirrhosis - surgery</subject><subject>Liver Transplantation</subject><subject>Lung - pathology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Myocardium - pathology</subject><subject>Pulmonary Artery - pathology</subject><subject>Pulmonary Veins - pathology</subject><subject>Retrospective Studies</subject><subject>Tunica Intima - pathology</subject><issn>1074-3022</issn><issn>1527-6473</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kM9LwzAcxYMoc05vXoWcPNmZNE3aHmX4CwZ6mOeQpWkXSZOapJP990Y25s3T9wvvw-O9B8A1RnOMUH5v4pwihCjCGJ2AKaZ5mbGiJKfpR2WREZTn5-AihM9ElQWrJ2BSVyVBdTEF_H00vbPC7-BWBDka4WHv_LBxxnVaCgPlRthOBagtlNr7jYtawkFErWwMcLSN8p3TtoNGb5WH0QsbBiNsTIizl-CsFSaoq8OdgY-nx9XiJVu-Pb8uHpaZLAhDWZNLkXKTmqqCCdxWuFRYEsZk2yjEyqZpaUuaum4YppVQ7boSrFKVSHUqWrRkBm73voN3X6MKkfc6SGVSEOXGwFlNSYVJmcC7PSi9C8Grlg9e96k_x4j_7slN5Mc9E35z8B3XvWqO8GHApNO9_q2N2v3rxZerP98f-ASCnQ</recordid><startdate>199901</startdate><enddate>199901</enddate><creator>Lamps, Laura W.</creator><creator>Carson, Kelly</creator><creator>Bradley, Anne L.</creator><creator>Pinson, C. Wright</creator><creator>Johnson, Joyce E.</creator><creator>Coogan, Alice C.</creator><creator>Hunter, Ellen B.</creator><creator>Clavien, Pierre A.</creator><creator>Washington, Mary Kay</creator><general>W.B. Saunders</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>199901</creationdate><title>Pulmonary vascular morphological changes in cirrhotic patients undergoing liver transplantation</title><author>Lamps, Laura W. ; Carson, Kelly ; Bradley, Anne L. ; Pinson, C. Wright ; Johnson, Joyce E. ; Coogan, Alice C. ; Hunter, Ellen B. ; Clavien, Pierre A. ; Washington, Mary Kay</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4360-d2ca527395e46a1f817e1c366cfde067ddf5f3d99d6158aefb8a68e8a469854f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>Adult</topic><topic>Female</topic><topic>Humans</topic><topic>Hypertension, Portal - pathology</topic><topic>Hypertension, Portal - surgery</topic><topic>Liver Cirrhosis - pathology</topic><topic>Liver Cirrhosis - surgery</topic><topic>Liver Transplantation</topic><topic>Lung - pathology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Myocardium - pathology</topic><topic>Pulmonary Artery - pathology</topic><topic>Pulmonary Veins - pathology</topic><topic>Retrospective Studies</topic><topic>Tunica Intima - pathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lamps, Laura W.</creatorcontrib><creatorcontrib>Carson, Kelly</creatorcontrib><creatorcontrib>Bradley, Anne L.</creatorcontrib><creatorcontrib>Pinson, C. Wright</creatorcontrib><creatorcontrib>Johnson, Joyce E.</creatorcontrib><creatorcontrib>Coogan, Alice C.</creatorcontrib><creatorcontrib>Hunter, Ellen B.</creatorcontrib><creatorcontrib>Clavien, Pierre A.</creatorcontrib><creatorcontrib>Washington, Mary Kay</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Liver Transplantation and Surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lamps, Laura W.</au><au>Carson, Kelly</au><au>Bradley, Anne L.</au><au>Pinson, C. Wright</au><au>Johnson, Joyce E.</au><au>Coogan, Alice C.</au><au>Hunter, Ellen B.</au><au>Clavien, Pierre A.</au><au>Washington, Mary Kay</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pulmonary vascular morphological changes in cirrhotic patients undergoing liver transplantation</atitle><jtitle>Liver Transplantation and Surgery</jtitle><addtitle>Liver Transpl Surg</addtitle><date>1999-01</date><risdate>1999</risdate><volume>5</volume><issue>1</issue><spage>57</spage><epage>64</epage><pages>57-64</pages><issn>1074-3022</issn><eissn>1527-6473</eissn><abstract>Cirrhosis and portal hypertension may be associated with pulmonary hypertension and pulmonary dysfunction. However, morphological pulmonary vascular lesions in patients with cirrhosis have not been well characterized morphometrically. We morphometrically evaluated pulmonary vessels in liver transplant recipients with pretransplantation cirrhosis and correlated our findings with pretransplantation cardiopulmonary function, postoperative course, and postmortem cardiopulmonary findings. Autopsy lung slides from 23 transplant recipients with pretransplantation cirrhosis were examined. External vessel diameter, intimal thickness, and arterial medial thickness were measured with a micrometer after pentachrome staining. The percent of total diameter comprised by intima or media was calculated for each vessel. Medical records were reviewed for smoking history, pretransplantation cardiopulmonary function testing, and postoperative course. Autopsy cases without liver or significant cardiopulmonary diseases, matched for age, sex, and smoking history, served as controls. Transplant recipients had significantly more pulmonary venous intimal thickening than matched controls (P < .0001). Sixty‐five percent (15 of 23) of these patients had some degree of pretransplantation pulmonary dysfunction, defined by abnormalities in pulmonary function tests, oxygen saturation, and/or increased pulmonary artery pressures. However, the severity of venous intimal thickening did not correlate with the severity of pretransplantation pulmonary dysfunction. Arterial intimal and medial thickness were not statistically significantly different from controls. Pulmonary venous intimal thickening and resultant luminal impingement are morphological findings not previously described in this population. The arterial lesion, when present, is similar to that seen in pulmonary hypertension from other causes. These pulmonary vascular lesions may be implicated in pulmonary dysfunction in patients with cirrhosis and may be associated with increased posttransplantation cardiopulmonary morbidity and mortality.</abstract><cop>Philadelphia, PA</cop><pub>W.B. 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| ispartof | Liver Transplantation and Surgery, 1999-01, Vol.5 (1), p.57-64 |
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| subjects | Adult Female Humans Hypertension, Portal - pathology Hypertension, Portal - surgery Liver Cirrhosis - pathology Liver Cirrhosis - surgery Liver Transplantation Lung - pathology Male Middle Aged Myocardium - pathology Pulmonary Artery - pathology Pulmonary Veins - pathology Retrospective Studies Tunica Intima - pathology |
| title | Pulmonary vascular morphological changes in cirrhotic patients undergoing liver transplantation |
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