Pulmonary complications of cirrhosis

Rajan Kochar, Moises I. Nevah Rubin, Michael B. Fallon

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

Pulmonary vascular complications of liver disease comprise two distinct clinical entities: hepatopulmonary syndrome (HPS-microvascular dilatation and angiogenesis) and portopulmonary hypertension (POPH-vasoconstriction and remodeling in resistance vessels). These complications occur in similar pathophysiologic environments and may share pathogenic mechanisms. HPS is found in 15% to 30% of patients with cirrhosis and its presence increases mortality and the risks of liver transplantation, particularly when hypoxemia is present. Contrast echocardiography and arterial blood gas analysis are required to establish the diagnosis. No medical therapies are available, although liver transplantation is effective in reversing the syndrome. POPH is found in 4% to 8% of patients undergoing liver transplantation evaluation, and the presence of moderate to severe disease significantly increases perioperative transplant mortality. Transthoracic echocardiography is recommended for screening and right-heart catheterization is required to establish the diagnosis. Medical therapies are increasingly effective in improving pulmonary vascular hemodynamics in POPH and may result in better perioperative outcomes.

Original languageEnglish (US)
Pages (from-to)34-39
Number of pages6
JournalCurrent gastroenterology reports
Volume13
Issue number1
DOIs
Publication statusPublished - Feb 1 2011
Externally publishedYes

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Keywords

  • Contrast echocardiography
  • Hepatopulmonary syndrome
  • Intrapulmonary shunting
  • Intrapulmonary vasodilation
  • Liver transplantation
  • Portopulmonary hypertension
  • Pulmonary hypertension
  • Pulmonary vascular complications of liver disease

ASJC Scopus subject areas

  • Gastroenterology

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