Pulmonary Complications of Cirrhosis
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Rajan Kochar & Moises I. Nevah Rubin & Michael B. Fallon
- چاپ و سال / کشور: 2010
Description
Pulmonary vascular complications of liver disease comprise two distinct clinical entities: hepatopulmonary syndrome (HPS—microvascular dilatation and angiogenesis) and portopulmonary hypertension (POPH— vasoconstriction and remodeling in resistance vessels). These complications occur in similar pathophysiologic environments and may share pathogenic mechanisms. HPS is found in 15% to 30% of patients with cirrhosis and its presence increases mortality and the risks of liver transplantation, particularly when hypoxemia is present. Contrast echocardiography and arterial blood gas analysis are required to establish the diagnosis. No medical therapies are available, although liver transplantation is effective in reversing the syndrome. POPH is found in 4% to 8% of patients undergoing liver transplantation evaluation, and the presence of moderate to severe disease significantly increases perioperative transplant mortality. Transthoracic echocardiography is recommended for screening and rightheart catheterization is required to establish the diagnosis. Medical therapies are increasingly effective in improving pulmonary vascular hemodynamics in POPH and may result in better perioperative outcomes
Curr Gastroenterol Rep (2011) 13:34–39 DOI 10.1007/s11894-010-0164-6 Published online: 2 December 2010
