Wearable echocardiography enables real-time perioperative monitoring in a pediatric liver transplant recipient with hepatopulmonary syndrome and pulmonary arteriovenous malformations: a case report.
4 affiliations
- 1Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, 610041, China.
- 2Sichuan Wismed Medical Technology Co. Ltd, Chengdu, China.
- 3Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, 610041, China. [email protected].
- 4Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, 610041, China. [email protected].
Abstract
Background
Hepatopulmonary syndrome (HPS) with pulmonary arteriovenous malformations (PAVMs) creates high risks of hemodynamic instability and gas embolism during pediatric liver transplantation. Transesophageal echocardiography is relatively contraindicated due to esophageal varices, while intermittent transthoracic echocardiography lacks the temporal resolution to capture transient events. This is the first report of continuous wearable echocardiography for real-time perioperative monitoring in a pediatric liver transplant recipient with HPS and PAVMs.Case presentation
A 3-year-old girl with biliary atresia and decompensated cirrhosis underwent deceased donor liver transplantation. Preoperative evaluation confirmed severe HPS with PAVMs. During surgery, fluid management was guided by continuous monitoring using wearable echocardiography to maintain hemodynamic stability. In particular, within 10 s after graft reperfusion, wearable echocardiography revealed numerous bright echogenic foci in all visualized cardiac chambers. This real-time finding provided immediate visual confirmation of gas embolism, which was associated with targeted multidisciplinary intervention. The surgery was successfully completed, and the patient was discharged on postoperative day 24.Conclusions
This is the first detailed report demonstrating the utility of wearable echocardiography for continuous, real-time cardiac monitoring in a pediatric liver transplant recipient with severe HPS and PAVMs. This technology may facilitate individualized fluid management and enable early warning of catastrophic complications in pediatric liver transplantation when standard echocardiographic modalities are contraindicated or insufficient.
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BibTeX
@article{ye2026wearable,
title = {{Wearable echocardiography enables real-time perioperative monitoring in a pediatric liver transplant recipient with hepatopulmonary syndrome and pulmonary arteriovenous malformations: a case report.}},
author = {Mao Ye and Pengjie Zhang and Chunling Jiang and Bin Zhou and Xinmei Yang and Haibo Song and Weiyi Zhang},
journal = {BMC pediatrics},
year = {2026},
month = aug,
doi = {10.1186/s12887-026-07440-y},
url = {https://europepmc.org/article/MED/42972513},
note = {CC BY},
}
RIS
TY - JOUR
TI - Wearable echocardiography enables real-time perioperative monitoring in a pediatric liver transplant recipient with hepatopulmonary syndrome and pulmonary arteriovenous malformations: a case report.
AU - Mao Ye
AU - Pengjie Zhang
AU - Chunling Jiang
AU - Bin Zhou
AU - Xinmei Yang
AU - Haibo Song
AU - Weiyi Zhang
PY - 2026
DA - 2026/08/04
JO - BMC pediatrics
DO - 10.1186/s12887-026-07440-y
UR - https://europepmc.org/article/MED/42972513
AB - Background Hepatopulmonary syndrome (HPS) with pulmonary arteriovenous malformations (PAVMs) creates high risks of hemodynamic instability and gas embolism during pediatric liver transplantation. Transesophageal echocardiography is relatively contraindicated due to esophageal varices, while intermittent transthoracic echocardiography lacks the temporal resolution to capture transient events. This is the first report of continuous wearable echocardiography for real-time perioperative monitoring in a pediatric liver transplant recipient with HPS and PAVMs.Case presentation A 3-year-old girl with biliary atresia and decompensated cirrhosis underwent deceased donor liver transplantation. Preoperative evaluation confirmed severe HPS with PAVMs. During surgery, fluid management was guided by continuous monitoring using wearable echocardiography to maintain hemodynamic stability. In particular, within 10 s after graft reperfusion, wearable echocardiography revealed numerous bright echogenic foci in all visualized cardiac chambers. This real-time finding provided immediate visual confirmation of gas embolism, which was associated with targeted multidisciplinary intervention. The surgery was successfully completed, and the patient was discharged on postoperative day 24.Conclusions This is the first detailed report demonstrating the utility of wearable echocardiography for continuous, real-time cardiac monitoring in a pediatric liver transplant recipient with severe HPS and PAVMs. This technology may facilitate individualized fluid management and enable early warning of catastrophic complications in pediatric liver transplantation when standard echocardiographic modalities are contraindicated or insufficient.
SN - 1471-2431
ER -