Rehabilitating patients with hepatopulmonary syndrome using living-relatedorthotopic liver transplant: A case report

The objective of this study was to rehabilitate a patient with hepatopulmon ary syndrome (HPS) who underwent living-related orthotopic liver transplant ation (LT). HPS is rare; it presents severe complication in patients with l iver disease. A 17-year-old woman with HPS developed portal hypertension af ter undergoing Kasai's surgery for congenital biliary atresia and underwent a living-related orthotopic LT. After LT, her allograft functioned well, b ut she continued to have hypoxemia and orthodeoxia. She was referred for re habilitation for disuse atrophy, contracture of hip and shoulder joints, le ft common peroneal nerve palsy, and rehabilitation for respiratory dysfunct ion. By day 106 after LT, her orthodeoxia and disuse atrophy had improved b ecause of daily exercise training and active joint range of motion exercise s. Patients with HPS have orthodeoxia and poor responsiveness to oxygen the rapy, and correction of hypoxemia after LT may be delayed. Therefore, rehab ilitation approaches for patients with HPS should be based on the pathophys iology and characteristics of HPS.