Pulmonary vascular complications of cirrhosis: hepatopulmonary syndrome and portopulmonary hypertension

Maïté Verstraeten, Sander Lefere, Sarah Raevens
Ghent University Hospital and Ghent University.
Belgium

Acta Clinica Belgica
Acta Clin Belg 2025;
DOI: 10.1080/17843286.2025.2456697

Abstract
Hepatopulmonary syndrome (HPS) and portopulmonary hypertension (POPH) are two distinct pulmonary vascular complications seen in patients with liver disease and/or portal hypertension. HPS is characterized by disturbed gas exchange and hypoxemia because of intrapulmonary vascular dilatations. POPH is defined by pulmonary arterial hypertension, which might lead to right heart failure. HPS affects up to 30% of patients with end-stage liver disease requiring liver transplantation. POPH is rarer and affects 1-5% of this patient population. If not recognized and left untreated, these disorders result in significant mortality. This review provides an update on HPS and POPH and discusses their clinical characteristics, screening and diagnostic modalities, and management, including the place of liver transplantation.

Category
Class I. Pulmonary Hypertension Associated with Liver Disease
Pulmonary Arteriovenous Malformations
Review Articles Concerning Pulmonary Vascular Disease

Age Focus: Pediatric Pulmonary Vascular Disease or Adult Pulmonary Vascular Disease

Fresh or Filed Publication: Fresh (PHresh). Less than 1-2 years since publication

Article Access
Free PDF File or Full Text Article Available Through PubMed or DOI: No

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