• Al-Aman Shaukat
  • Adnan Zar
  • Muhammad Zuhaid
  • Safa Saadat Afridi
  • Abid Ullah Khan


Background: Hepatitis B and C related chronic liver diseases have led to development of a serious threat to the people of South Asia. The main aim of this study was to evaluate the correlation of magnitude of arterial deoxygention to the severity of liver disease. Methods: It was a hospital based cross sectional descriptive study, carried out in the Medical Department of Khyber Teaching Hospital Peshawar. All in all 115 patients were assessed for the severity of the liver diseases and were correlated with arterial deoxygenation using linear regression models. Results: Male to female ratio was 1.5:1. Males infected with hepatitis B, hepatitis C and both were 9, 60 and 1, while females suffered from hepatitis B, Hepatitis C and both were 2, 42 and 1 respectively. The linear relationship between A-a DO2 with severity of liver disease showed positive correlation while PO2 showed negative correlation with severity of liver disease. Conclusion: There was a positive correlation between A-a DO2 and severity of liver diseases while PO2 and severity of liver diseases showed negative correlationKeywords: Chronic liver disease, severity, arterial oxygenation, deviance, correlation


Ali I, Siddique L, Rehman LU, Khan NU, Iqbal A, Munir I, et al. Prevalence of HCV among high risk groups in Khyber Pukhtoonkhwa. Virol J 2011;8:296.

Naeem SS, Siddiqui EU, Kazi AN, Khan S, Abdullah FE, Adhi I. Prevalence of Hepatitis ‘B’ and hepatitis ‘C’ among preoperative cataract patients in Karachi. BMC Res Notes 2012;5:492.

Khan MS, Shafiullah, Sajjid M. Hepatitis B and C: An alarming situation in southern part of Khyber Pukhtoonkhwa, Pakistan. Ann Pak Inst Med Sci 2011;7(4):228–32.

Sawant P, Vishistha C, Nasa M. Management of Cardio-Pulmonary Complications of Cirrhosis.

Int J Hepatol 2011;2011:280569.

Ho V. Current concepts in the management of hepatopulmonary Syndrome.

Vasc Health Risk Manag 2008;4(5):1035–41.

Schenk P, Fuhrmann V, Madl C, Funk G, Lehr S, Kandel O, et al. Hepatopulmonary syndrome: prevalence and predictive value of various cut offs for arterial oxygenation and their clinical consequences. Gut 2002;51(6):853–9.

Paç FA, Cağdaş DN, Akdoğan M, Zengin NI, Saşmaz N. Hepatopulmonary Syndrome associated with Budd-Chiari syndrome. Anadolu Kardiyol Derg 2010;10(3):286–8.

Kaymakoglu S, Kahraman T, Kudat H, Demir K, Cakaloglu Y, Adalet I, et al. Hepatopulmonary syndrome in noncirrhotic portal hypertensive patients. Dig Dis Sci 2003;48(3):556–60.

De BK, Sen S, Sanyal R. Hepatopulmonary syndrome in noncrirrhotic portal hypertension. Ann Intern Med


Bouguila J, Rouatbi H, Tej A, Chabchoub I, Trimech B, El Ajmi S, et al. Hepatopulmonary Syndrome: A complication of Type 1 Gaucher disease. Rev Pneumol Clin 2012;68(1):58–62.

Maganty K, Ghanta R, Bejarano P, Weppler D, Tekin A, Moon J, et al. Liver transplantation for Hepato-pulmonary syndrome due to non-cirrhotic portal hypertension. Transplant Proc 2011;43(7):2814–6.

Schouten JN, Garcia Pagan JC, Valla DC, Janssen HL. Idiopathic non-cirrhotic portal hypertension.

Hepatology 2011;54(3):1071–81.

Zang ZJ, Yang CQ. Progress in investigating the pathogenesis of Hepatopulmonary Syndrome.

Hepatobiliary Pancreat Dis Int 2010;9(4):355–60.

Schenk P, Schöniger-Hekele M, Fuhrmann V, Madl C, Silberhumer G, Müller C. Prognostic significance of Hepatopulmonary Syndrome in patients with cirrhosis. Gastroenterology 2003;125(4):1042–52.

Yi HM, Wang GS, Yi SH, Yang Y, Cai CJ, Chen GH. Prospective evaluation of post-operative outcome after liver transplantation in Hepato-pulmonary syndrome patients. Chin Med J (Engl) 2009;122(21):2598–602.

Fallon MB, Krowka MJ, Brown RS, Trotter JF, Zacks S, Roberts KE, et al; Impact of Hepato-Pulmonary Syndrome on quality of life and survival in liver transplant candidates. Gastroenterology 2008;135(4):1168–75.

Bozbas SS, Eyuboglu F. Evaluation of Liver Transplant candidates: A pulmonary perspective. Ann Thorac Med 2011;6(3):109–14.

Varghese J, Ilias-basha H, Dhanasekaran R, Singh S, Venkataraman J. Hepatopulmonary syndrome: Past to Present. Ann Hepatol 2007;6(3):135–42.

Chayanupatkul M, Liangpunsakul S. Cirrhotic cardiomyopathy: review of pathophysiology and treatment. Hepatol Int 2014;8(3):308–15.

Arquedas MR, Singh H, Faulk DK, Fallon MB. Utility of Pulse Oximetry screening for Hepatopulmonary Syndrome. Clin Gastroenterology Hepatol 2007;5(6):749–54.

Suzuki H, Ohuchi H, Hiraumi Y, Yasuda K, Echigo S. Effect of postural change on oxygen saturation and respiration in patients after the Fontan operation: platypnea and orthodeoxia. Int J Cardiol 2006;106(2):211–7.

Hussain SF, Mekan SF. Platypnea and Orthodeoxia: Report of two a cases and review of literature. South Med J 2004;97(7):657–62.

Machicao VI, Fallon MB. Hepatopulmonary Syndrome. Semin Respir Crit Care Med 2012;33(1):11–6.

Saleemi S. Portopulmonary Hypertension. Ann Thorac Med 2010;5(1):5–9.

Aldenkortt F, Aldenkortt M, Caviezel L, Waeber JL, Weber A, Schiffer E. Portopulmonary hypertension and hepatopulmonary syndrome. World J Gastroenterol 2014;20(25):8072–81.

Møller S, Henriksen JH, Bendtsen F. Extrahepatic complications to cirrhosis and portal hypertension: Haemodynamic and homeostatic aspects. World J Gastroenterol 2014;20(42):15499–517.

Salzano A, Sirico D, Golia L, Faga V, Flora M, Bossone E, et al. The portopulmonary hypertension: an overview from diagnosis to treatment. Monaldi Arch Chest Dis 2013;80(2):66–8.

Mancuso L, Scordato F, Pieri M, Valerio E, Mancuso A. Management of portopulmonary hypertension: new perspectives. World J Gastroenterol 2013;19(45):8252–7.

Al-Hamoudi WK. Cardiovascular Changes in Cirrhosis: Pathogenesis and Clinical Implications. Saudi J Gastroenterol 2010;16(3):145–53.

Moller S, Henriksen JH. Cardiopulmonary complications in chronic liver disease. World J Gastroenterol 2006;12(4):526–38.

Baik SK, Fouad TR, Lee SS. Cirrhotic Cardiomyopathy. Orphanet J Rare Dis 2007;2:15.

Møller S, Henriksen JH. Cardiovascular complications of cirrhosis. Gut 2008;57(2):268–78.