Liver transplantation following preoperative closure of intrapulmonary shunts

Intrapulmonary shunts producing basal resting hypoxemia and necessitating the continual use of supplemental oxygen by two cirrhotic men were closed prior to liver transplantation with octreotide acetate, a somatostatin analogue. The closure of these shunts was monitored by serial blood gas determinations and shunt estimations using two different techniques. Partial closure of the shunts with preoperative octreotide acetate administration allowed liver transplantation to proceed with successful engraftment and eventual permanent closure of the shunts. Currently, both patients are alive and well with normal liver function and blood gases and, most important, have no requirement for supplemental oxygen.