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Portopulmonary hypertension and hepatopulmonary syndrome: a clinician-oriented overview

European respiratory review, 2012-09, Vol.21 (125), p.223-233 [Peer Reviewed Journal]

ERS 2012 2012 ;ISSN: 0905-9180 ;EISSN: 1600-0617 ;DOI: 10.1183/09059180.00007211 ;PMID: 22941887

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Title:
Portopulmonary hypertension and hepatopulmonary syndrome: a clinician-oriented overview
Author: Porres-Aguilar, Mateo ; Altamirano, Jose T ; Torre-Delgadillo, Aldo ; Charlton, Michael R ; Duarte-Rojo, Andres
Subjects: Arterial Pressure ; Cirrhosis ; Hemodynamics ; hepatopulmonary syndrome ; Hepatopulmonary Syndrome - diagnosis ; Hepatopulmonary Syndrome - epidemiology ; Hepatopulmonary Syndrome - physiopathology ; Hepatopulmonary Syndrome - therapy ; Humans ; Hypertension, Portal - diagnosis ; Hypertension, Portal - epidemiology ; Hypertension, Portal - physiopathology ; Hypertension, Portal - therapy ; Hypertension, Pulmonary - diagnosis ; Hypertension, Pulmonary - epidemiology ; Hypertension, Pulmonary - physiopathology ; Hypertension, Pulmonary - therapy ; Liver Circulation ; liver transplantation ; portal hypertension portopulmonary hypertension ; Prognosis ; Pulmonary Circulation ; pulmonary hypertension ; Review ; Risk Factors ; Vascular Resistance ; Vasodilation
Is Part Of: European respiratory review, 2012-09, Vol.21 (125), p.223-233
Description: 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.
Publisher: England: European Respiratory Society
Language: English
Identifier: ISSN: 0905-9180
EISSN: 1600-0617
DOI: 10.1183/09059180.00007211
PMID: 22941887
Source: GFMER Free Medical Journals
MEDLINE
PubMed Central
Alma/SFX Local Collection
DOAJ Directory of Open Access Journals

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Portopulmonary hypertension and hepatopulmonary syndrome: a clinician-oriented overview

ERS 2012 2012 ;ISSN: 0905-9180 ;EISSN: 1600-0617 ;DOI: 10.1183/09059180.00007211 ;PMID: 22941887

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