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The hepatopulmonary syndrome.

G A Abrams1, M B Fallon

  • 1UAB Liver Center, Division of Gastroenterology and Hepatology, University of Alabama at Birmingham, Birmingham, Alabama 35294-0007, USA.

Clinics in Liver Disease
|May 1, 1997
PubMed
Summary

Hepatopulmonary syndrome (HPS), a complication of liver disease, causes low oxygen levels due to lung blood vessel changes. Diagnosis involves imaging tests, and treatment options include medication and liver transplantation.

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Area of Science:

  • Cardiology
  • Pulmonology
  • Hepatology

Background:

  • Hepatopulmonary syndrome (HPS) is a serious complication in patients with chronic liver disease or portal hypertension.
  • It is characterized by intrapulmonary vasodilation leading to arterial deoxygenation.

Purpose of the Study:

  • To present clinical and basic science studies on the pathophysiology of HPS.
  • To provide a diagnostic algorithm for HPS.
  • To review current medical therapies and outcomes of liver transplantation for HPS.

Main Methods:

  • Review of clinical and basic science literature on HPS.
  • Development of a diagnostic algorithm utilizing contrast echocardiography, lung perfusion scans, and pulmonary angiography.
  • Analysis of medical therapy efficacy and liver transplantation outcomes.

Main Results:

  • Intrapulmonary vasodilation and arterial deoxygenation are key pathophysiological features of HPS.
  • A structured diagnostic approach incorporating echocardiography, perfusion scans, and angiography aids in HPS identification.
  • Medical management and liver transplantation represent viable treatment strategies.

Conclusions:

  • HPS is a significant manifestation of advanced liver disease requiring accurate diagnosis.
  • The proposed diagnostic algorithm offers a systematic approach to identifying HPS.
  • Liver transplantation remains a crucial therapeutic option for eligible HPS patients.

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