Pulmonary vascular complications of liver disease

Jason S. Fritz, Michael B. Fallon, Steven M. Kawut

Research output: Contribution to journalReview articlepeer-review

54 Scopus citations

Abstract

Hepatopulmonary syndrome and portopulmonary hypertension are two pulmonary vascular complications of liver disease. The pathophysiology underlying each disorder is distinct, but patients with either condition may be limited by dyspnea. A careful evaluation of concomitant symptoms, the physical examination, pulmonary function testing and arterial blood gas analysis, and echocardiographic, imaging, and hemodynamic studies is crucial to establishing (and distinguishing) these diagnoses. Our understanding of the pathobiology, natural history, and treatment of these disorders has advanced considerably over the past decade; however, the presence of either still increases the risk of morbidity and mortality in patients with underlying liver disease.There isnoeffective medical treatment for hepatopulmonary syndrome. Although liver transplantation can resolve hepatopulmonary syndrome, there appears to be worse survival evenwith transplantation. Liver transplantation poses a very high risk of death in those with significant portopulmonary hypertension, where targeted medical therapies may improve functional status and allow successful transplantation in a small number of select patients.

Original languageEnglish (US)
Pages (from-to)133-143
Number of pages11
JournalAmerican journal of respiratory and critical care medicine
Volume187
Issue number2
DOIs
StatePublished - Jan 15 2013
Externally publishedYes

Keywords

  • Hepatopulmonary syndrome
  • Hypertension
  • Liver cirrhosis
  • Pulmonary
  • Pulmonary circulation

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

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