14 September 2021: Original Paper
Impact of Liver Transplantation on Carbon Monoxide Production as Measured by Arterial Carboxyhemoglobin Levels in Cirrhotic Patients with and without Hepatopulmonary Syndrome
Ralph Llewel Sabang 1ABCDEF* , Mohammad Abu-Hishmeh 2ABC , Roxana Bodin 3DEF , Oleg Epelbaum 4ABCDEFDOI: 10.12659/AOT.932009
Ann Transplant 2021; 26:e932009
Figure 1 Graphical depiction of the heme-oxygenase (HO) pathway. Heme, a product of hemoglobin degradation, is engulfed by liver macrophages and then broken down to iron (Fe2+), biliverdin, and carbon monoxide in a reaction catalyzed by the inducible enzyme HO-1. This enzyme’s activity can be upregulated by multiple factors, including liver injury. Carbon monoxide, in turn, exerts several downstream effects, including vasodilation.