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Published on: May 11, 2015
Portopulmonary hypertension
Ravi P Nayak1, Dechun Li, George M Matuschak
1Division of Pulmonary, Critical Care and Sleep Medicine, 1402 South Grand Boulevard, St. Louis, MO 63104, USA. nayakrp@slu.edu
Current Gastroenterology Reports
|January 27, 2009
Summary
Porto-pulmonary hypertension (POPH) requires portal hypertension but is unrelated to liver damage severity. Diagnosis involves echocardiography and right heart catheterization, with limited treatment options available.
Area of Science:
- Cardiology
- Hepatology
- Pulmonology
Background:
- Porto-pulmonary hypertension (POPH) development is independent of the cause or severity of liver damage.
- Portal hypertension is a confirmed prerequisite for developing pulmonary hypertension.
- Current treatment strategies lack robust comparative data from randomized controlled trials.
Purpose of the Study:
- To review the current understanding of porto-pulmonary hypertension (POPH).
- To discuss diagnostic modalities and management strategies for POPH.
- To highlight the implications of POPH in liver transplant candidates.
Main Methods:
- Literature review of existing studies on POPH.
- Analysis of diagnostic criteria and screening tests.
- Evaluation of current and potential pharmacologic treatments.
Main Results:
- Transthoracic echocardiography is the primary screening tool for POPH.
- Right heart catheterization is essential for definitive POPH diagnosis.
- Diuretics and oxygen are standard management; vasomodulators are used for severe cases.
Conclusions:
- POPH management is challenging due to limited evidence-based pharmacologic options.
- Moderate to severe POPH increases perioperative mortality risk in liver transplant recipients.
- Vasomodulating agents like epoprostenol and bosentan show promise in managing POPH and facilitating transplantation.
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