Late recurrence and rapid evolution of severe hepatopulmonary syndrome after liver transplantation

Recurrence of hepatopulmonary syndrome (HPS) after orthotopic liver transpl antation (OLT) in an adult has never been reported. We describe a 23-year-o ld woman who initially underwent OLT because of debilitating and severe HPS associated with nonalcoholic steatohepatitis (NASH). Although the clinical resolution of HPS was well documented day 117 post-OLT, the reappearance o f NASH was documented by liver biopsy. Severe hypoxemia because of recurren t HPS rapidly evolved beginning approximately day 700 post-OLT. Retransplan tation was attempted, but the patient died post-OLT of sepsis and/or multio rgan failure. Copyright (C) 1999 by the American Association for the Study of Liver Diseases.