Portopulmonary Hypertension and Hepatopulmonary Syndrome

Hepatopulmonary syndrome delays postoperative recovery and increases pulmonary complications after hepatectomy

“…For postoperative outcome, HBV-HCC patients with HPS stayed the longest time of PACU and had the longest oxygen absorption time after extubation, as well as the highest incidence of PPCs, indicating that short-term postoperative outcomes in HPS patients are worse than for non-HPS patients (patients in IPVD and control groups). Compared to non-HPS patients, HPS patients were more likely to have PPCs after liver transplantation and require a longer oxygen supply for 1 month or even 3 months [7]. This might be related to HPS patients being prone to postoperative hypoxia, which may lead to the translocation of intestinal bacteria, significantly increased endotoxin and NO levels in the blood, and ultimately, aggravated hypoxemia, which is more likely to cause pulmonary complications [33].…”

“…Hepatopulmonary syndrome (HPS), a severe pulmonary complication of advanced liver disease, is characterized by intrapulmonary vascular dilation (IPVD) and pathological pulmonary angiogenesis and hypoxemia, which significantly increases the perioperative mortality and risk of pulmonary complications, decreasing patient quality of life [6]. The incidence of HPS in cirrhotic patients is reportedly 4–47% [7]. The only curable treatment remains liver transplantation.…”

Progressive dyspnoea in a patient with idiopathic non-cirrhotic portal hypertension

“…A diagnosis of PoPH is not an absolute contraindication to liver transplantation. However, pulmonary haemodynamics (including mPAP and PVR) and right ventricular function should be incorporated in the pre-transplant assessment, as right heart dysfunction could result in graft congestion and malfunction [4]. Furthermore, severe PoPH is considered an absolute contraindication to liver transplantation in most centres [5].…”