[Portopulmonary hypertension: Updated review]

Area of Science:

• Cardiology
• Hepatology
• Pulmonology

Background:

• Portopulmonary hypertension (PPH) is a rare complication of chronic liver disease, with unknown prevalence in Mexico.
• PPH is the fourth most frequent subtype of pulmonary arterial hypertension.
• Chronic liver diseases are highly prevalent in Mexico, suggesting a potential underdiagnosis of PPH.

Purpose of the Study:

• To highlight the diagnostic challenges and clinical significance of Portopulmonary hypertension (PPH) in Mexico.
• To emphasize the impact of PPH on orthotopic liver transplantation (OLT) outcomes.
• To discuss current therapeutic strategies and future considerations for PPH management.

Main Methods:

• Diagnosis relies on echocardiogram and right cardiac catheterisation in patients with suspected pulmonary hypertension or awaiting OLT.
• Assessment of PPH severity is crucial for determining OLT candidacy and perioperative risk.
• Review of existing literature on PPH diagnosis, management, and transplantation outcomes.

Main Results:

• PPH significantly increases perioperative mortality in OLT candidates.
• Specific therapies can improve outcomes for OLT candidates with moderate to severe PPH.
• PPH can be an absolute contraindication for OLT.

Conclusions:

• Accurate diagnosis and management of PPH are critical for improving outcomes in liver disease patients, especially OLT candidates.
• Therapeutic interventions are essential for managing PPH and optimizing OLT success.
• The role of combined lung-liver or heart-lung-liver transplantation for PPH requires further investigation.