RT Journal Article
T1 Hepatopulmonary syndrome: What we know and what we would like to know.
A1 Grilo-Bensusan, Israel
A1 Pascasio-Acevedo, Juan Manuel
K1 Contrast echocardiography
K1 Hepatopulmonary syndrome
K1 Liver cirrhosis
K1 Liver transplantation
K1 Macroaggregated albumin lung perfusion scan
AB 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.
YR 2016
FD 2016
LK http://hdl.handle.net/10668/10285
UL http://hdl.handle.net/10668/10285
LA en
DS RISalud
RD Apr 13, 2025