Pulmonary Complications of Liver Cirrhosis: A Concise Review

Abstract

Pulmonary complications, in the form of hepatopulmonary syndrome (HPS), portopulmonary hypertension (PPH), and hepatic hydrothorax (HH), are rare occurrences in patients with portal hypertension and liver cirrhosis. These complications are associated with high morbidity and mortality. The only effective therapy is liver transplantation in patients who are suitable. In this chapter, each condition will be outlined in detail from clinical presentations to diagnosis and treatment as well as the challenges that clinicians may have encountered in managing patients with these complications.

Clinical Practice Guidelines for Liver Transplantation in Saudi Arabia

“…Both HPS and portopulmonary hypertension (POPH), granted MELD score of 22 with an increase in MELD points equivalent to a 10% increase in mortality every 3 months, provided PaO 2 remains less than 60 mmHg, for patients with HPS and MPAP remains less than 35 mm Hg and pulmonary vascular resistance less than 400 dyn/s/cm for patients with POPH. 170 Management and follow-up of liver transplant listed patients. Although the current allocation system allows timely access to donor organs for the sickest patients, a substantial percentage of patients are still removed from the transplant list for death or clinical deterioration due to infection-related removal or death related to ESLD complications.…”

“…Both HPS and portopulmonary hypertension (POPH), granted MELD score of 22 with an increase in MELD points equivalent to a 10% increase in mortality every 3 months, provided PaO 2 remains less than 60 mmHg, for patients with HPS and MPAP remains less than 35 mm Hg and pulmonary vascular resistance less than 400 dyn/s/cm for patients with POPH. 170 …”