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World J Gastroenterol. Jul 7, 2014; 20(25): 8072-8081
Published online Jul 7, 2014. doi: 10.3748/wjg.v20.i25.8072
Published online Jul 7, 2014. doi: 10.3748/wjg.v20.i25.8072
Portopulmonary hypertension and hepatopulmonary syndrome
Florence Aldenkortt, Marc Aldenkortt, Laurence Caviezel, Jean Luc Waeber, Anne Weber, Eduardo Schiffer, Division of Anesthesiology, Department of Anesthesiology, Clinical Pharmacology and Intensive Care, Geneva University Hospitals, 1211 Geneva, Switzerland
Author contributions: All authors contributed equally to this work.
Correspondence to: Florence Aldenkortt, MD, Staff Anesthesiologist, Division of Anesthesiology, Department of Anesthesiology, Clinical Pharmacology and Intensive Care, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva, Switzerland. florence.aldenkortt@hcuge.ch
Telephone: +41-79-5532173 Fax: +41-22-3727690
Received: November 28, 2013
Revised: March 18, 2014
Accepted: April 5, 2014
Published online: July 7, 2014
Revised: March 18, 2014
Accepted: April 5, 2014
Published online: July 7, 2014
Core Tip
Core tip: Portopulmonary hypertension (POPH) and hepatopulmonary syndrome (HPS) are frequent complications of liver disease. Both conditions result from diminished hepatic clearance of splanchnic vasoactive substances. They cause pulmonary vasoconstriction in POPH resulting in elevated pulmonary pressure, right ventricular dysfunction and intrapulmonary shunts with hypoxemia in HPS. The only lasting treatment is liver transplantation (LT). Whereas LT results in the disappearance of HPS, its effect on POPH is unpredictable. The anesthesiologist plays a central role in managing HPS and POPH during LT as preoperative screening and grading of the disease allows the selection of appropriate therapies.