Portopulmonary Hypertension*

Budhiraja, Rohit; Hassoun, Paul M.

doi:10.1378/chest.123.2.562

Cited by 137 publications

(9 citation statements)

References 170 publications

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“…The development of PPH is independent of the cause of PH, and it is often seen in cirrhosis. It is however, also described in those with PH due to nonhepatic pathologies such as portal venous thrombosis [71, 77]. PH seems to be the driving force of PAH.…”

Section: Pulmonary Manifestationsmentioning

confidence: 99%

“…The most common presenting symptom is progressive dyspnea on exertion [80] and less frequently fatigue, palpitations, syncope, hemoptysis, orthopnea, and chest pain. On physical exam, classical features include edema, an accentuated P2 and a systolic murmur, indicating tricuspid regurgitation [71, 77, 80]. In severe cases, signs and symptoms of right-heart failure can be noted.…”

Section: Pulmonary Manifestationsmentioning

confidence: 99%

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Clinical Manifestations of Portal Hypertension

Al-Busafi

McNabb‐Baltar

Farag

et al. 2012

International Journal of Hepatology

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The portal hypertension is responsible for many of the manifestations of liver cirrhosis. Some of these complications are the direct consequences of portal hypertension, such as gastrointestinal bleeding from ruptured gastroesophageal varices and from portal hypertensive gastropathy and colopathy, ascites and hepatorenal syndrome, and hypersplenism. In other complications, portal hypertension plays a key role, although it is not the only pathophysiological factor in their development. These include spontaneous bacterial peritonitis, hepatic encephalopathy, cirrhotic cardiomyopathy, hepatopulmonary syndrome, and portopulmonary hypertension.

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Section: Pulmonary Manifestationsmentioning

confidence: 99%

Section: Pulmonary Manifestationsmentioning

confidence: 99%

Clinical Manifestations of Portal Hypertension

Al-Busafi

McNabb‐Baltar

Farag

et al. 2012

International Journal of Hepatology

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“…An increase in plasma brain natriuretic peptide (BNP) indicates stress on the right ventricle. The differential diagnosis of dyspnea in a patient of liver disease includes intrinsic cardiopulmonary conditions such as chronic obstructive pulmonary disease, pneumonia, pulmonary embolism, congestive heart failure, valvular heart disease, and conditions related to underlying liver disease and portal hypertension such as ascites, hepatic hydrothorax, and muscle wasting [61, 62]. …”

Section: Portopulmonary Hypertensionmentioning

confidence: 99%

Management of Cardiopulmonary Complications of Cirrhosis

Sawant

Vashishtha

Nasa

2011

International Journal of Hepatology

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Advanced portal hypertension accompanying end-stage liver disease results in an altered milieu due to inadequate detoxification of blood from splanchnic circulation by the failing liver. The portosystemic shunts with hepatic dysfunction result in an increased absorption and impaired neutralisation of the gastrointestinal bacteria and endotoxins leads to altered homeostasis with multiorgan dysfunction. The important cardiopulmonary complications are cirrhotic cardiomyopathy, hepatopulmonary syndrome, portopulmonary hypertension, and right-sided hydrothorax.

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“…If PVR is not elevated, the prognosis after LT is good. [34] If PVR is high, LT should be cancelled owing to the high probability of failure of the donor organ.…”

Section: Portopulmonary Hypertensionmentioning

confidence: 99%

Evaluation of liver transplant candidates: A pulmonary perspective

Bozbas¹,

Eyüboğlu²

2011

Ann Thorac Med

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Chronic liver disease is one of the leading causes of mortality and morbidity in the worldwide adult population. Liver transplant is the gold standard therapy for end-stage liver disease and many patients are on the waiting list for a transplant. A variety of pulmonary disorders are encountered in cirrhotic patients. Pleura, lung parenchyma, and pulmonary vasculature may be affected in these patients. Hypoxemia is relatively common and can be asymptomatic. Hepatopulmonary syndrome should be investigated in hypoxic cirrhotic patients. Gas exchange abnormalities are common and are generally correlated with the severity of liver disease. Both obstructive and restrictive types of airway disease can be present. Abnormal diffusion capacity is the most frequently observed pulmonary function disorder in patients with cirrhosis. Hepatic hydrothorax is another finding which is usually seen in conjunction with, but occasionally without ascites. Portopulmonary hypertension is a complication of long standing liver dysfunction and when severe, is accepted as a containdication to liver transplant. Since respiratory disorders are common and have significant impact on postoperative outcome in patients undergoing liver transplant, a careful preoperative pulmonary assessment is important.

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Portopulmonary Hypertension*

Cited by 137 publications

References 170 publications

Clinical Manifestations of Portal Hypertension

Clinical Manifestations of Portal Hypertension

Management of Cardiopulmonary Complications of Cirrhosis

Evaluation of liver transplant candidates: A pulmonary perspective

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