TREATMENT OF HEPATOPULMONARY SYNDROME WITH ALLIUM-SATIVUM L. (GARLIC)- A PILOT TRIAL

No medical therapy exists for subjects with hepatopulmonary syndrome ( HPS). A patient with HPS was reported to have improvement in arterial oxygenation while self-administering garlic. Our goal was to determine whether a standardized garlic powder improves arterial oxygenation an d dyspnea in subjects with HPS. A prospective, open label uncontrolled pilot study in 15 subjects with HPS were administered garlic powder c apsules daily for a minimum of 6 months. Arterial blood gases were det ermined every 4-8 weeks, in the same position on room air, and a subje ctive dyspnea transition index was reported. Six of 15 subjects (40%, confidence interval: 0.15-65) had at least a 10 mmHg increase in the P O2 or decrease in the alveolar-arterial gradient. The mean pre- and po starterial difference in these patients were: PO2 (14 +/- 4 mmHg) and alveolar-arterial gradient (18 +/- 5 mmHg). All 6 subjects who respond ed to garlic had less dyspnea on exertion. Garlic improved arterial ox ygenation in younger subjects (mean 40 versus 56 years old; p = 0.021) or those with lower macroaggregated albumin shunt fractions (mean 21 versus 44%, p = 0.058). Garlic may improve arterial oxygenation and sy mptoms in patients with hepatopulmonary syndrome and warrants further investigation.