Pulmonary Complications of Portal Hypertension

Rodrigo Cartin-Ceba, Michael Joseph Krowka

Research output: Contribution to journalReview article

Abstract

The most common pulmonary complications of chronic liver disease are hepatic hydrothorax, hepatopulmonary syndrome, and portopulmonary hypertension. Hepatic hydrothorax is a transudative pleural effusion in a patient with cirrhosis and no evidence of underlying cardiopulmonary disease. Hepatic hydrothorax develops owing to the movement of ascitic fluid into the pleural space. Hepatopulmonary syndrome and portopulmonary hypertension are pathologically linked by the presence of portal hypertension; however, their pathophysiologic mechanisms are significantly different. Hepatopulmonary syndrome is characterized by low pulmonary vascular resistance secondary to intrapulmonary vascular dilatations and hypoxemia; portopulmonary hypertension features elevated pulmonary vascular resistance and constriction/obstruction within the pulmonary vasculature.

Original languageEnglish (US)
JournalClinics in liver disease
DOIs
StateAccepted/In press - Jan 1 2019

Fingerprint

Hepatopulmonary Syndrome
Hydrothorax
Portal Hypertension
Hypertension
Vascular Resistance
Lung
Liver
Ascitic Fluid
Pleural Effusion
Constriction
Blood Vessels
Liver Diseases
Dilatation
Fibrosis
Chronic Disease

Keywords

  • Cirrhosis
  • Hepatic hydrothorax
  • Hepatopulmonary syndrome
  • Liver transplant
  • Portal hypertension
  • Portopulmonary hypertension

ASJC Scopus subject areas

  • Hepatology

Cite this

Pulmonary Complications of Portal Hypertension. / Cartin-Ceba, Rodrigo; Krowka, Michael Joseph.

In: Clinics in liver disease, 01.01.2019.

Research output: Contribution to journalReview article

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AB - The most common pulmonary complications of chronic liver disease are hepatic hydrothorax, hepatopulmonary syndrome, and portopulmonary hypertension. Hepatic hydrothorax is a transudative pleural effusion in a patient with cirrhosis and no evidence of underlying cardiopulmonary disease. Hepatic hydrothorax develops owing to the movement of ascitic fluid into the pleural space. Hepatopulmonary syndrome and portopulmonary hypertension are pathologically linked by the presence of portal hypertension; however, their pathophysiologic mechanisms are significantly different. Hepatopulmonary syndrome is characterized by low pulmonary vascular resistance secondary to intrapulmonary vascular dilatations and hypoxemia; portopulmonary hypertension features elevated pulmonary vascular resistance and constriction/obstruction within the pulmonary vasculature.

KW - Cirrhosis

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KW - Hepatopulmonary syndrome

KW - Liver transplant

KW - Portal hypertension

KW - Portopulmonary hypertension

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