Portopulmonary hypertension and hepatopulmonary syndrome: A clinician-oriented overview

Mateo Porres-Aguilar, Jose T. Altamirano, Aldo Torre-Delgadillo, Michael R. Charlton, Andres Duarte-Rojo

Research output: Contribution to journalReview article

51 Scopus citations

Abstract

Liver disease and portal hypertension can be associated with pulmonary vascular complications, including portopulmonary hypertension (POPH), characterised by an elevated mean pulmonary artery pressure secondary to an increased pulmonary vascular resistance, and hepatopulmonary syndrome (HPS), characterised by hypoxaemia due to pulmonary vasodilatation and shunting. Although clear diagnostic guidelines exist for both conditions on the basis of echocardiography, right heart catheterisation and arterial blood gases, there is considerable variation between centres regarding diagnosis and management of these conditions. Awareness of evaluation and management algorithms for POPH and HPS are critical for optimisation of outcomes in patients with these conditions. Key aspects of management of POPH and HPS include identification of patients likely to benefit from liver transplantation (LTx) and management before and after LTx. Although both disorders may improve after LTx, severe forms of POPH represent a contraindication to LTx. Novel approaches to the treatment of POPH and HPS offer new management options that may expand the pool of transplantable patients and improve overall outcomes.

Original languageEnglish (US)
Pages (from-to)223-233
Number of pages11
JournalEuropean Respiratory Review
Volume21
Issue number125
DOIs
StatePublished - Sep 1 2012

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Keywords

  • Cirrhosis
  • Hepatopulmonary syndrome
  • Liver transplantation
  • Portal hypertension
  • Portopulmonary hypertension
  • Pulmonary hypertension

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Porres-Aguilar, M., Altamirano, J. T., Torre-Delgadillo, A., Charlton, M. R., & Duarte-Rojo, A. (2012). Portopulmonary hypertension and hepatopulmonary syndrome: A clinician-oriented overview. European Respiratory Review, 21(125), 223-233. https://doi.org/10.1183/09059180.00007211