Can liver transplantation achieve similar effects at high altitudes compared with plains: case report

In orthotopic liver transplantation, particular emphasis must be placed on the unique physiologic, pathologic, and clinical features in residents living in areas at high vs low altitude. Hypobaric hypoxia, hypothermia, heavy radiation, high wind speed, and superevaporation at high altitudes may lead to various diseases. These features have progressive effects on cardiopulmonary and central nervous system functions. A high concentration of red cells in the circulation is likely to result in an increased incidence of hepatic artery and portal vein thrombosis. The immune system is also affected at high altitudes. Exposure to high altitude, which is associated with decreased oxygen pressure, can result in oxidation-reduction stress, enhanced generation of reactive oxygen and nitrogen species, and related oxidative damage to lipids, proteins, and DNA. Our male patient with liver cirrhosis caused by chronic hepatitis B virus infectionunderwent orthotopic liver transplantation in Tibet with a successful outcome and good long-term survival.