Portopulmonary hypertension in liver transplant candidates

Table 1 Summary on assessment, grading and therapy for portopulmonary hypertension

TTDE in all patients prior to transplant surgery, systolic PAP ≥ 30 mmHg

RHC in selected cases, confirmation and grading of PoPHT:

Mild PoPHT: mPAP > 25 mmHg, PVR > 240 dynes/s per cm-5, PCWP ≤ 15 mmHg, allow LT

Moderate PoPHT: mPAP 35-45 mmHg, PVR > 240 dynes/s per cm-5, PCWP ≤ 15 mmHg if responder to vasodilator therapy, allow LT

Severe PoPHT: mPAP > 45 mmHg, PVR > 240 dynes/s per cm-5, PCWP ≤ 15 mmHg, medical therapy

PoPHT: Portopulmonary hypertension; TTDE: Transthoracic Doppler echocardiography; PAP: Pulmonary artery pressure; RHC: Right heart catheterization; PVR: Pulmonary vascular resistance; LT: Liver transplantation.