Publication:
Hepatopulmonary syndrome: What we know and what we would like to know.

No Thumbnail Available

Date

2016

Authors

Grilo-Bensusan, Israel
Pascasio-Acevedo, Juan Manuel

Advisors

Journal Title

Journal ISSN

Volume Title

Publisher

Metrics
Google Scholar
Export

Research Projects

Organizational Units

Journal Issue

Abstract

Hepatopulmonary syndrome (HPS) is characterized by abnormalities in blood oxygenation caused by the presence of intrapulmonary vascular dilations (IPVD) in the context of liver disease, generally at a cirrhotic stage. Knowledge about the subject is still only partial. The majority of the information about the etiopathogenesis of HPS has been obtained through experiments on animals. Reported prevalence in patients who are candidates for a liver transplantation (LT) varies between 4% and 32%, with a predominance of mild or moderate cases. Although it is generally asymptomatic it does have an impact on their quality of life and survival. The diagnosis requires taking an arterial blood gas sample of a seated patient with alveolar-arterial oxygen gradient (AaO2) ≥ 15 mm Hg, or ≥ 20 mm Hg in those over 64 years of age. The IPVD are identified through a transthoracic contrast echocardiography or a macroaggregated albumin lung perfusion scan ((99m)Tc-MAA). There is currently no effective medical treatment. LT has been shown to reverse the syndrome and improve survival rates, even in severe cases. Therefore the policy of prioritizing LT would appear to increase survival rates. This paper takes a critical and clinical look at the current understanding of HPS, as well as the controversies surrounding it and possible future research.

Description

MeSH Terms

Angiography
Blood Gas Analysis
Dyspnea
Echocardiography
Hepatopulmonary Syndrome
Humans
Liver Cirrhosis
Liver Transplantation
Lung
Oximetry
Perfusion Imaging
Prevalence
Radiography, Thoracic
Radionuclide Imaging
Radiopharmaceuticals
Respiratory Function Tests
Severity of Illness Index
Technetium Tc 99m Aggregated Albumin
Tomography, X-Ray Computed

DeCS Terms

CIE Terms

Keywords

Contrast echocardiography, Hepatopulmonary syndrome, Liver cirrhosis, Liver transplantation, Macroaggregated albumin lung perfusion scan

Citation