Back to Search
Start Over
Portopulmonary hypertension.
- Source :
-
Seminars in respiratory and critical care medicine [Semin Respir Crit Care Med] 2012 Feb; Vol. 33 (1), pp. 17-25. Date of Electronic Publication: 2012 Mar 23. - Publication Year :
- 2012
-
Abstract
- Portopulmonary hypertension (POPH) refers to the presence of pulmonary arterial hypertension (PAH) in patients with portal hypertension. Pulmonary hypertension in patients with liver disease or portal hypertension can be due to multiple mechanisms, including hyperdynamic (high-flow) state, increased pulmonary venous congestion, and vascular constriction or obstruction of the pulmonary arterial bed. Vascular obstruction to pulmonary arterial flow, reflected by increased pulmonary vascular resistance (PVR), is a key parameter that defines POPH. Among patients with portal hypertension, reported incidence rates of POPH range from 2 to 9%. Long-term survival in cases of POPH is poor. Favorable responses to pulmonary vasodilator/vasomodulatory therapy have been observed, but prospective, randomized trials are lacking. Severe POPH with right ventricular failure despite vasodilator therapy is associated with poor outcomes in the setting of liver transplantation (LT) and is considered a contraindication to LT. The post-LT course of patients with moderate POPH is unpredictable, but most patients can be weaned from PAH-specific therapy over time.<br /> (Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.)
- Subjects :
- Contraindications
Humans
Hypertension, Portal etiology
Hypertension, Portal mortality
Hypertension, Portal physiopathology
Hypertension, Portal therapy
Hypertension, Pulmonary etiology
Hypertension, Pulmonary mortality
Hypertension, Pulmonary physiopathology
Hypertension, Pulmonary therapy
Liver Transplantation adverse effects
Liver Transplantation standards
Vasodilator Agents therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1098-9048
- Volume :
- 33
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Seminars in respiratory and critical care medicine
- Publication Type :
- Academic Journal
- Accession number :
- 22447257
- Full Text :
- https://doi.org/10.1055/s-0032-1301731