1Untersuchungen zu Störungen von Lungenfunktion, Gasaustausch und kardiopulmonaler Leistungsfähigkeit bei Langzeitüberlebenden nach LebertransplantationKlaus Walldorf 234meinen Eltern gewidmet5181.11.291.310111.41.512132142.1736#37515162.217728#4051819140#5086#26125#50129#5520197#5496#7621275#55116#5122254#5555#5039#50125#5523182#5439#5055#50130#9924737#296252.326733#4042728737#3642.429302.52.62.73147#33323.1736#532333.234560#39735435#37536452#38524#2637736#41938736#3713.339736#5094041636#400637#39142762#45343736#3663.444736#212736#3734546736#3694748601#301600#298601#29849603#7973.5503.6514524.153602#97854600#3284.255602#3274.356575585.159605.261625.3636465665.46768697071727374751038#70167677 Abkürzungsverzeichnis7 Literaturverzeichnis787980818283848586878889 Danksagung90 Erklärung91 Lebenslauf92 Veröffentlichungen93deInhaltsverzeichnisHilfe Literaturverzeichnis 1.Deutsche Stiftung Organtransplantation. Pressemitteilung vom 30.1.2001. 2.Deutsche Stiftung Organtransplantation. Organspende und Transplantation in Deutschland 1999, ISBN-Nr.3-9803248-9-3 3.Krowka MJ, Dickson ER et al.: A prospective study of pulmonary function and gas exchange following liver transplantation, Chest 1992: 102: pp.1161-1166. 4.Ewert R, Mutze S et al.: High prevalence of pulmonary diffusion abnormalities without interstitial changes in long-term survivors of liver transplantation, Transpl. Int. 1999: 12: pp.222-228. 5.Hourani JM, Bellamy PE et al.: Pulmonary dysfunction in advanced liver disease: frequent occurrence of an abnormal diffusing capacity, Am. J Med. 1991: 90: pp.693-700. 6.Battaglia SE, Pretto JJ et al.: Resolution of gas exchange abnormalities and intrapulmonary shunting following liver transplantation [see comments], Hepatology 1997: 25: pp.1228-1232. 7.Knoop M, Bechstein WO et al.: Clinical significance of recurrent primary biliary cirrhosis after liver transplantation, Transpl. Int. 1996: 9(Suppl 1): pp.S115-119. 8.Philit F, Wiesendanger T et al.: Late resolution of hepatopulmonary syndrome after liver transplantation, Respiration 1997: 64: pp.173-175. 9.Scott V, Miro A et al.: Reversibility of the hepatopulmonary syndrome by orthotopic liver transplantation, Transplant. Proc. 1993: 25: pp.1787-1788. 10.Thorens JB, Junod AF. Hypoxaemia and liver cirrhosis: a new argument in favour of a diffusion-perfusion defect, Eur Respir. J 1992: 5: pp.754-756. 11.Chao Y, Wang SS et al.: Effect of large-volume paracentesis on pulmonary function in patients with cirrhosis and tense ascites, J Hepatol. 1994: 20: pp.101-105. 12.Krowka MJ, Cortese DA. Pulmonary aspects of chronic liver disease and liver transplantation, Mayo Clin. Proc. 1985: 60: pp.407-418. 13.Ettinger NA, Trulock EP. Pulmonary considerations of organ transplantation. Part 1, Am. Rev. Respir. Dis. 1991: 143: pp.1386-1405. 14.DiCecco SR, Wieners RH et al.: Assessment of nutritional status of patients with end-stage liver disease undergoing liver transplantation., Mayo Clin. Proc. 1989: 64: pp.95-102. 15.Dantzker DR. The influence of cardiovasvular function on gas exchange, Clin. Chest Med. 1983: 4: pp.149-159. 16.Lotterer E, Fleig WE . Das hepatopulmonale Syndrom [hepatopulmonary syndrome], Schweiz. Rundsch. Med. Prax. 1997: 86: pp.104-108. 17.Hopkins WE, Waggoner AD et al.: Frequency and significance of intrapulmonary right-to-left shunting in end-stage hepatic disease, Am. J Cardiol. 1992: 70: pp.516-519. 18.Jensen DM, Pothamsetty S et al.: Clinical manifestation of cirrhotic patients with intrapulmonary shunts, Gastroenterology 1994: 106(Nr.4 Part 2): pp.A912. 19.Naeije R, Melot C et al.: Pulmonary hemodynamics in liver cirrhosis, Sem. Resp. Med. 1985: 7: pp.164-179. 20.Rodriguez Roisin R, Roca J. Hepatopulmonary syndrome: the paradigm of liver-induced hypoxaemia, Baillieres. Clin. Gastroenterol. 1997: 11: pp.387-406. 21.Lange PA, Stoller JK. The hepatopulmonary syndrome [see comments], Ann. Intern. Med. 1995: 122: pp.521-529. 22.Krowka MJ. Hepatopulmonary syndrome versus portopulmonary hypertension: distinctions and dilemmas [editorial; comment], Hepatology 1997: 25: pp.1282-1284. 23.Robin ED, Horn B et al.: Detection, quantification and pathophysiology of lung "spiders", Trans. Assoc. Am. Physicians 1975: 88: pp.202-215. 24.Robin ED, Laman D et al.: Platypnea related to orthodeoxea caused by true vascular lung shunts, N. Engl. J Med. 1976: 294: pp.941-943. 25.Eriksson LS, Soderman C et al.: Normalization of ventilation/perfusion relationships after liver transplantation in patients with decompensated cirrhosis: evidence for a hepatopulmonary syndrome, Hepatology 1990: 12: pp.1350-1357. 26.Ruff F, Hughes JM et al.: Regional lung function in patients with hepatic cirrhosis, J Clin. Invest. 1971: 50: pp.2403-2413. 27.Hamilton G, Phing RC et al.: The relationship between prostacyclin activity and pressure in the portal vein, Hepatology 1982: 2: pp.236-242. 28.Shijo H, Sasaki H et al.: Effects of indomethacin on hepatogenic pulmonary angiodysplasia, Chest 1991: 99: pp.1027-1029. 29.Bruix J, Bosch J et al.: Effects of prostaglandin inhibition on systemic and hepatic hemodynamics in patients with cirrhosis of the liver, Gastroenterology 1985: 88: pp.430-435. 30.Ebeid AM, Escourrou J et al .: Hepatic inactivation of vasoactive intestinal peptide in man and dog, Ann. Chir. 1978: 188: pp.28-33. 31.Henriksen JH, Staun-Olsen P et al.: Vasoactive intestinal polypeptide (VIP) in cirrhosis: arteriovenous extraction in different vascular beds, Scand. J Gastroenterol. 1980: 15: pp.787-792. 32.Hörtnagl H, Singer EA et al.: Substance P is markedly increased in plasma of patients with hepatic coma, Lancet 1984: 1: pp.480-483. 33.Claria J, Jimenez W et al.: Pathogenesis of arterial hypotension in cirrhotic rats with ascites: role of endogenous nitric oxide, Hepatology 1992: 15: pp.343-349. 34.Pizcueta P, Pique JM et al.: Modulation of hyperdynamic circulation of cirrhotic rats by nitric oxide inhibition, Gastroenterology 1992: 103: pp.1909-1915. 35.Sieber CC, Groszmann RJ. Role of nitric oxide in the in vitro splanchnic vascular hyporeactivity in cirrhotic rats, Gastroenterology 1993: 104: pp.1750-1754. 36.Gines P, Jimenez W et al.: Atrial natriuretic factor in cirrhosis with ascites: plasma levels, cardiac release and splanchnic extraction, Hepatology 1988: 8: pp.636-642. 37.Caramelo C, Fernandez-Gallardo S et al.: Increased levels of plateled-activating factor in blood from patients with cirrhosis of the liver, Eur J Clin. Invest. 1987: 17: pp.7-11. 38.Henriksen H, Ring-Larsen H et al.: Circulating noradrenaline and central haemodynamics in patients with cirrhosis, Scand. J Gastroenterol. 1985: 20: pp.1185-1190. 39.Bates D. Respiratory Funktion Disease. 3rd edition. WB Saunders Company.

Philadelphia

1989 40.Crapo RO, Morris AH. Standardized single breath normal values for carbon monoxide diffusing capacity, Am. Rev. Respir. Dis. 1981: 123: pp.185-189. 41.Jaeger MasterLab. Gebrauchsanleitung Teil I und II, Jaeger GmbH

Würzburg

2000 Version 3.3 42.Grippi MA. Pulmonary Pathophysiology, Lippincott's Pathophysiology Series. J. B. Lippincott Company 1995 43.Chang SC, Chang HI et al.: Effects of Body Position and Age on Membrane Diffusing Capacity and Pulmonary Capillary Blood Volume, Chest 1992: 102: pp.139-142. 44.Stam H, Kreuzer FJA et al.: Effect of lung volume and positional changes on pulmonary diffusing capacity and its components, J Appl. Physiol. 1991: 71: pp.1477-1488. 45.Jensen WA, Rose RM et al.: Pulmonary complications of orthotopic liver transplantation, Transplantation 1986: 42: pp.484-490. 46.Afessa B, Gay PC et al.: Pulmonary complications of orthotopic liver transplantation, Mayo Clin. Proc. 1993: 68: pp.427-434. 47.Barkholt L, Ericzon BG et al.: Infections in human liver recipients: different patterns early and late after transplantation, Transpl. Int. 1993: 6: pp.77-84. 48.von Son WJ, Peset R et al.: Cytomegalovirus infection after renal transplant recipients, Transplantation 1987: 44: pp.149-150. 49.Groen H.M, Bogaard JM et al.: Diffusion Capacity in Heart Transplant Recipients, Chest 1992: 102: pp.456-460. 50.Morales P, Cremades MJ et al.: Effect of cyclosporin on lung diffusing capacity in renal transplant patients, Transpl. Int. 1995: 8: pp.481-484. 51.Stoller JK, Moodie D et al.: Reduction of intrapulmonary shunt and resolution of digital clubbing associated with primary biliary cirrhosis after liver transplantation [see comments], Hepatology 1990: 11: pp.54-58. 52.Ikeda S, Sera Y et al.: Resolution of cirrhosis-related pulmonary shunting in two children with a transplanted liver, Transpl. Int. 1996: 9: pp.596-599. 53.Campillo B, Fouet P et al.: Submaximal oxygen consumption in liver cirrhosis. Evidence of severe functional aerobic impairment, J Hepatol. 1990: 10: pp.163-167. 54.Grose RD, Nolan J et al.: Exercise-induced left ventricular dysfunction in alcoholic and non-alcoholic cirrhosis [see comments], J Hepatol. 1995: 22: pp.326-332. 55.Epstein SK, Ciubotaru RL et al.: Analysis of impaired exercise capacity in patients with cirrhosis, Dig. Dis. Sci. 1998: 43: pp.1701-1707. 56.Tarter RE, Panzak G et al.: Isokinetic muscle strength and its association with neuropsychological capacity in cirrhotic alcoholics, Alcohol Clin. Exp. Res. 1997: 21: pp.1-6. 57.Andersen H, Borre M et al.: Decreased muscle strength in patients with alcoholic liver cirrhosis in relation to nutritional status, alcohol abstinence, liver function, and neuropathy, Hepatology 1998: 27: pp.1200-1206. 58.Renlund DG, Taylor DO et al.: Exercise capacity after heart transplantation: influence of donor and recipient characteristics, J Heart Lung Transplant. 1996: 15(1): pp.16-24. 59.Mercier JG, Hokanson JF et al.: Effects of cyclosporine A on skeletal muscle mitochondrial respiration and endurance time in rats, Am. J Respir. Crit. Care Med. 1995: 151: pp.1532-1536. 60.Weiner P, Azgad Y et al.: Inspiratory muscle training during treatment with corticosteroids in humans, Chest 1995: 107: pp.1041-1044. 61.Herold G. Innere Medizin, Eine vorlesungsorientierte Darstellung, Dr. med. Gerd Herold,

Köln

2000 62.European Community for Steel and Coal. Standardized lung function testing, Eur Respir. J 1993: 6(Suppl 16): pp.1-100. 63.Gardner NW. The CO2 Response: usefulness and uncertainties. Eur Respir. J 1993: 6: pp.611-613. 64.Schmidt W. Angewandte Lungenfunktionsprüfung, Einführung in Theorie und Praxis, Dustri-Verlag Dr. Karl Feistle

München-Deisenhofen

1983 65.Cotes JE, Chinn DJ et al.: Standardization of the Measurement of Transfer Factor (Diffusing Capacity), Eur Respir. J 1993: 6(Suppl 16): pp.41-52. 66.Tammeling GJ, Quanjer PH. Physiologie der Atmung, Dr. Karl Thomae GmbH,

Biberach an der Riss

1984 67.Crapo RO, Gardner RM et al.: Single Breath Carbon Monoxide Diffusing Capacity (Transfer Factor), Am. Rev. Respir. Dis. 1987: 136: pp.1299-1307. 68.Jones RS, Meade F. A theoretical and experimental analysis of anomalities in the estimation of pulmonary diffusing capacity by the single breath method. Quaterky J of Experimental Physiology 1961: pp.131-143. 69.Weinberger S, Johnson T et al.: Clinical significance of pulmonary function tests. Use and interpretation of the single-breath diffusion capacity, Chest 1980: 78(3): pp.483-488. 70.Single breath carbon monoxide diffusing capacity (transfer factor). Recommendations for a standard technique. Statement of the American Thoracic Society, Am. Rev. Respir. Dis. 1987: 136: pp.1299-1307. 71.American Thoracic Society. Single-breath carbon monoxide diffusing capacity (transfer factor). Recommendations for a standard technique-1995 update, Am. J Respir. Crit. Care Med. 1995: 152: pp.2185-2198. 72.Hilpert P. [Variation of the carbon monoxide diffusing capacity of the lung with the hemoglobin concentration of the blood], Respiration 1971: 28: pp.518-525. 73.Roughton FJW, Forster RE. Relative importance of diffusion and chemical reaction rates in determining rate of exchange of gases in the human lung, with special reference true diffusing capacity of pulmonary membrane and volume of blood in the lung capillaries. J Appl. Physiol. 1957: 11: pp.290-302. 74.Puri S, Baker L et al.: Reduced alveolar-capillary membrane diffusion capacity in chronic heart failure, Circulation 1995: 91: pp.2769-2774. 75.Laier-Groeneveld G, Criée CP. Die intermittierende Selbstbeatmung bei chronisch obstruktiver Lungenerkrankung, Med. Klin. 1996: 91(Sondernr.2): pp.2-6. 76.Criée CP. Analysis of inspiratory mouth pressures, Prax. Klin. Pneumol. 1988: 42(Suppl 2): pp.820-826. 77.Criée CP, Laier-Groeneveld G et al.: Die Atempumpe, Atemw. -Lungenkrkh. 1991: 17: pp.94-101. 78.Murray JF. The Normal Lung, The basis for diagnosis and treatment of pulmonary disease, W. B. Saunders Company.

Philadelphia

1986 79.Karg O, Bullemer F. Die Funktion der Atempumpe - Mundverschudruck P0.1 und maximaler Inspirationsdruck Pimax, Jaeger info Ausgabe 4/94 1994: 4: pp.5-7. 80.Hautmann H, Hefele S et al.: Maximal inspiratory mouth pressures (PIMAX) in healthy subjects-- what is the lower limit of normal?, Respir. Med. 2000. Jul. 2000: 94: pp.689-693. 81.Habedank D, Reindl I et al.: Ventilatory efficiency and exercise tollerance in 101 healthy volunteers, Eur J Appl Physiol 1998: 77: pp.421-426. 82.Weber KT, Kinasewitz GT et al.: Oxygen utilisation and ventilation during exercise in patients with chronic heart failure, Circulation 1982: 65: pp.1213-1223. 83.Wasserman K, Hansen JE et al.: Principles of Exercise Testing & Interpretation: Including Pathophysiology and Clinical Applications, Lippincott 1999: 3rd Edition (ISBN-Nr: 0-683306464) 84.Beaver W, Lamarra N et al.: Breath-by-breath measurement of true alveolar gas exchange, J Appl. Physiol. 1981: 51: pp.1662-1675. 85.Stephenson AL, Yoshida EM et al.: Impaired exercise performance after successful liver transplantation, Transplantation 2001: 72(6): pp.1161-1164. 86.Remy-Jardin M, Remy J et al.: Assessment of Diffuse Infiltrative Lung Disease:Comparison of Conventional CT and High-Resolution CT, Radiology 1991: 181: pp.157-162. 87.Bessis L, Gallard P et al.: High-resolution CT of parenchymal lung disease: precise correlation with histologic findings, Radiographics 1992: 12: pp.45-58. 88.McAdams HP, Erasmus J et al.: The hepatopulmonary syndrome: radiologic findings in 10 patients, AJR. Am. J Roentgenol. 1996: 166: pp.1379-1385. 89.Lörcher V, Schmidt H. HR-CT der Lunge. Ein Lehrbuch zu Untersuchungstechnik, systematischer Befundanalyse und Differentialdiagnostik bei Erwachsenen und Kindern, Georg Thieme Verlag.

Stuttgart-New York

1996 90.Schiller NB, Shah PM et al .: Recommendations for quantification of the left ventricle by two-dimensional echocardiography, J Am Soc. Echocardiogr. 1989: 2: pp.358 91.Al-Rawas OA, Carter R et al.: The alveolar-capillary membrane diffusing capacity and the pulmonary capillary blood volume in heart transplant candidates, Heart 2000: 83: pp.156-160. 92.Metra M, Dei Cas L et al.: Exercise Hyperventilation Chronic Congestive Heart Failure, and Its Relation to Functional Capacity and Hemodynamics., Am. J Cardiol. 1992: 70: pp.622-628. 93.Krowka MJ, Cortese DA. Pulmonary aspects of liver disease and liver transplantation, Clin. Chest Med. 1989: 10: pp.593-616. 94.Chang SC, Chang HI et al.: Therapeutic effects of diuretics and paracentesis on lung function in patients with non-alcoholic cirrhosis and tense ascites, J Hepatol. 1997: 26: pp.833-838. 95.Stanescu D. Small Airways Obstruction Syndrome, Chest 1999: 116: pp.231-233. 96.Macklem PT. The Physiology of Small Airways, Am. J Respir. Crit. Care Med. 1998: 157: pp.S181-S183. 97.Shaw RJ, Djukanovic R et al.: The role of small airways in lung disease, Respir. Med. 2002: 96: pp.67-80. 98.Xu X, Dockery DW et al.: Effects of cigarette smoking on rate of loss of pulmonary function in adults: a longitudinal assessment, Am. Rev. Respir. Dis. 1992: 146: pp.1345-1348. 99.Ashley F, Kannel WB et al.: Pulmonary function: relation to aging, cigarette habit, and mortality, Ann. Intern. Med. 1975: 82: pp.739-745. 100.Boss‚ R, Sparrow D et al.: Longitudinal Effect of Age and Smoking Cessation on Pulmonary Function, Am. Rev. Respir. Dis. 1981: 123: pp.378-381. 101.Janssens JP, Pache JC et al.: Physiological changes in respiratory function associated with ageing, Eur Respir. J 1999: 13: pp.197-205. 102.Paoletti P, Viegi G et al.: Residual volume in a general population. Effects of body size, age, cigarette smoking, and respiratory symptoms, Chest 1992: 102: pp.1209-1215. 103.Mohamed R, Freeman JW et al.: Pulmonary Gas Exchange Abnormalities in Liver Transplant Candidates, Liver Transpl. 2002: 8(9): pp.802-808. 104.Stanley NN, Woodgate DJ. Mottled chest radiograph and gas transfer defect in chronic liver disease, Thorax 1972: 27: pp.315-323. 105.Sherrill DL, Enright PL et al.: Predictors of longitudinal change in diffusing capacity over 8 years, Am. J Respir. Crit. Care Med. 1999: 160 : pp.1883-1887. 106.Gulsvik A, Bakke P et al.: Single breath transfer factor for carbon monoxide in an asymptomatic population of never smokers, Thorax 1992: 47: pp.167-173. 107.Burrows B, Kasik JE et al.: Clinical usefulness of the single-breath pulmonary diffusing capacity test, Am. Rev. Respir. Dis. 1961: 84(6): pp.789-806. 108.Witt C, Borges AC et al.: Respiratory muscle weakness and normal ventilatory drive in dilative cardiomyopathy, Eur Heart J 1997: 18: pp.1322-1328. 109.Puri S, Baker BL et al.: Increased alveolar capillary membrane resistance to gas transfer in patients with chronic heart failure, Br. Heart J. 1994: 72: pp.140-144. 110.Al-Rawas OA, Carter R et al.: Mechanisms of pulmonary transfer factor decline following heart transplantation, Eur J Cardiothorac. Surg. 2000: 17: pp.355-361. 111.Kleerup EC, Tashkin DP et al.: Membrane diffusing capacity and capillary blood volume in liver transplant candidates [Abstract], Am. J Respir. Crit. Care Med. 1994: 149: pp.788A 112.Webb LF, Johnson JE. Pulmonary vascular changes in patients with hepatic fibrosis: a clinically silent morphologic lesion, Lab Invest 1995: supplement : p.A908 113.Matsubara O, Nakamura T et al.: Histometrical investigation of the pulmonary artery in severe hepatic disease, J Pathol 1984: 143: pp.31-37. 114.Lamps LW, Carson K et al.: Pulmonary vascular morphological changes in cirrhotic patients undergoing liver transplantation, Liver Transpl. Surg. 1999: 5: pp.57-64. 115.Hedenstierna G, Soderman C et al.: Ventilation-perfusion inequality in patients with non-alcoholic liver cirrhosis, Eur Respir. J 1991: 4: pp.711-717. 116.Bussières LM, Pflugfelder PW et al.: Evolution of resting lung function in the first year after cardiac transplantation, Eur Respir. J 1995: 8: pp.959-962. 117.Egan JJ, Kalra S et al.: Pulmonary diffusion abnormalities in heart transplant recipients. Relationship to cytomegalovirus infection, Chest 1993: 104: pp.1085-1089. 118.Fanfulla F, Locatelli F et al.: Pulmonary complications and respiratory function changes after bone marrow transplantation in children, Eur Respir. J 1997: 10: pp.2301-2306. 119.Ewert R, Opitz C et al.: Abnormalities of Pulmonary Diffusion Capacity in Long-term survivors After Kidney Transplantation, Chest 2002: 122: pp.639-644. 120.Tarter RE. Quality of life following liver transplantation, Hepatogastroenterology. 1998: 45: pp.1398-1403. 121.Banner BR. Exercise physiology and rehabilitation after heart transplantation, J Heart Lung Transplant. 1992: 11: pp.237-240. 122.Kempeneers G, Noakes TD et al.: Skeletal muscle limits the exercise tolerance of renal transplant recipients: effects of a graded exercise training program, Am. J Kidney Dis. 1990: 16: pp.57-65. 123.Theodore J, Morris AJ et al.: Cardiopulmonary function at maximum tolerable constant work rate exercise following human heart-lung transplantation, Chest 1987: 92: pp.433-439. 124.Miyoshi S, Trulock EP et al.: Cardiopulmonary exercise testing after single and double lung transplantation, Chest 1990: 97: pp.1130-1136. 125.Beyer N, Aadahl M et al.: Improved Physical Performance After Orthotopic Liver Transplantation, Liver Transpl. Surg. 1999: 5(4): pp.301-309. 126.Wiesinger GF, Quittan M et al.: Physical performance and health-related quality of life in men on a liver transplantation waiting list, J Rehabil. Med. 2001: 33: pp.260-265. 127.Wong F, Girgrah N et al.: The cardiac response to exercise in cirrhosis, Gut 2001: 49: pp.268-275. 128.Myers RP, Lee SS. Cirrhotic cardiomyopathy and liver transplantation. Liver Transpl. 2000: 6(Suppl 1): pp.S44-S52. 129.Ma Z, Lee SS. Cirrhotic cardiomyopathy, getting to the heart of the matter, Hepatology 1996: 24: pp.451-459. 130.Liu H, Lee SS. Cardiopulmonary dysfunction in cirrhosis, J Gastroenterol. Hepatol. 1999: 14: pp.600-608. 131.Hussaini SH, Oldroyd B et al.: Effects of orthotopic liver transplantation on body composition, Liver 1998: 18: pp.173-179. 132.Aargaard NK, Andersen H et al.: Muscle strength, Na,K-pumps, magnesium and potassium in patients with alcoholic liver cirrhosis - relation to spironolactone, J Int Med 2002: 252: pp.56-63. 133.Kelly SM, Rosa A et al.: Inspiratory Muscle Strength and Body Composition in Patients Receiving Total Parenteral Nutrition Therapie, Am. Rev. Respir. Dis. 1984: 130: pp.33-37. 134.Plank LD, Metzger DJ et al.: Sequential changes in the metabolic response to orthotopic liver transplantation during the first year after surgery, Ann. Surg. 2001: 234(2): pp.245-255. 135.Roske AE, Plauth M. Liver transplantation, body composition, and substrate utilization: does organ transplantation normalize the metabolic situation of the patient? Nutrition. 1999: 15: pp.504-505. 136.Campos ACL, Matias JEF et al.: Nutritional aspects of liver transplantation, Curr. Opin. Clin. Nutr. Metab. Care 2002: 5: pp.297-307. 137.Urbano-Marquez A, Estruch R et al.: The effects of alcoholism on skeletal and cardiac muskle, N. Engl. J Med. 1989: 320: pp.409-415. 138.Fernandez-Sola J, Junyent JMG et al.: Alcoholic myopathies, Curr. Opin. Neurol. 1996: 9: pp.400-405. 139.Jacobsen EB, Hamberg O et al.: Reduced Mitochondrial Adenosine Triphosphate Synthesis in Skeletal Muscle in Patients with Child-Pugh Class B and C Cirrhosis, Hepatology 2001: 34: pp.7-12. 140.Keogh JB, Tsalamandris C et al.: Bone loss at the proximal femur and reduced lean mass following liver transplantation: a longitudinal study, Nutrition. 1999: 15: pp.661-664. 141.Hussaini SH, Soo S et al.: Risk factors for loss of lean body mass after liver transplantation, Appl. Radiat. Isot. 1998: 49: pp.663-664. 142.Roske AE, Schütz T et al.: Effect of liver transplantation on substrate utilisation and body composition., Clin. Nutr. 1997: 16(Suppl.2): p.16 143.Cabre E, Gassull MA. Nutritional and metabolic issues in cirrhosis and liver transplantation, Curr. Opin. Clin. Nutr. Metab. Care 2000: 3: pp.345-54. 144.Plauth M, Schütz T. Cachexia in liver cirrhosis, Int J Card 2002: 85: pp.83-87. 145.Cook CD, Mead J et al.: Static volume-pressure characteristics of the respiratory system during maximal efforts, J Appl. Physiol. 1964: 19: pp.1016-1022. 146.Ringqvist T. The ventilatory capacity in healthy subjects, Scand. J Clin. Lab. Invest. 1966: 18(Suppl.88): pp.1-179. 147.van Balkom, van der Heijden et al.: Corticosteroid-induced myopathy of the respiratory muscles, Neth. J Med. 1994: 45: pp.114-122. 148.Weiner P, Azgad Y et al.: [Effect of corticosteroids on inspiratory muscle function], Harefuah. 1994: 127: pp.456-60. 149.McAlister VC, Grant DR et al.: Right phrenic nerve injury in orthotopic liver transplantation, Transplantation 1993: 55: pp.826-830. 150.Lands LC, Smountas AA et al.: Maximal exercise capacity and peripheral skeletal muscle function following lung transplantation, J Heart Lung Transplant. 1999: 18: pp.113-120. 151.Chua TP, Anker SD et al.: Inspiratory muscle strength is a determinant of maximum oxygen consumption in chronic heart failure, Br. Heart J. 1995: 74: pp.381-385. 152.Salvadori A, Fanari P et al.: Oxygen uptake and cardiac performance in obese and normal subjects during exercise, Respiration 1999: 66: pp.25-33. 153.Reuben A. Long-Term Management of the Liver Transplant Patient: Diabetes, Hyperlipidemia, and Obesity, Liver Transpl. 2001: 7: pp.13-21. 154.Dudley F, Rochester MD. Respiratory Muscle and Ventilatory Failure: 1993 Perspective, Am. J Med. Sci. 1993: 305(6): pp.394-402. 155.Kelly TM, Jensen RL et al.: Maximum respiratory pressures in morbidly obese subjects., Respiration 1988: 54: pp.73-77. 156.Everhart JE, Lombardero M et al.: Weight change and obesity after liver transplantation: incidence and risk factors, Liver Transpl. Surg. 1998: 4: pp.285-296. 157.Sheiner PA, Magliocca JF et al.: Long-term medical complications in patients surviving > or = 5 years after liver transplant, Transplantation 2000. Mar. 15. 2000: 69: pp.781-789. 158.Stegall MD, Everson G et al.: Metabolic complications after liver transplantation. Diabetes, hypercholesterolemia , hypertension, and obesity, Transplantation 1995: 60: pp.1057-1060. 159.Canzanello VJ, Schwartz L et al.: Evolution of cardiovascular risk after liver transplantation: a comparison of cyclosporine A and tacrolimus (FK506), Liver Transpl. Surg. 1997: 3: pp.1-9. 160.Mor E, Facklam D et al.: Weight gain and lipid profile changes in liver transplant recipients: long-term results of the American FK506 Multicenter Study, Transplant. Proc. 1995: 27: p.1126 161.Hokanson JF, Mercier JG et al.: Cyclosporine A decreases rat skeletal mascle mitochondrial respiration in vitro, Am. J Respir. Crit. Care Med. 1995: 151: pp.1848-1851. 162.Francaux M, Versieux L et al.: Muscle energetics in immunosuppressed patients, Transplant. Proc. 2000: 32: pp.415-417. 163.Messner-Pellenc P, Brasileiro C et al.: Exercise intolerance in patients with chronic heart failure: role of pulmonary diffusing limitation, Eur Heart J 1995: 16: pp.201-209.