Portopulmonary hypertension and right heart failure in patients with cirrhosis

Current Opinion in Anaesthesiology

Volumn 23, Issue 2, 2010, Pages 145-150

  Ramsay, Michael ^a  

^a NONE

Author keywords

Liver cirrhosis; Liver transplantation; Portopulmonary hypertension; Pulmonary vasodilators; Right ventricular failure

Indexed keywords

BOSENTAN; DIURETIC AGENT; ENDOTHELIN RECEPTOR ANTAGONIST; ILOPROST; ISOSORBIDE 5 NITRATE; NITRIC OXIDE; OXYGEN; PHOSPHODIESTERASE V INHIBITOR; PROSTACYCLIN; PROSTANOID; SILDENAFIL; UNIPROST; VASODILATOR AGENT;

CONTINUOUS INFUSION; DIAGNOSTIC VALUE; DRUG EFFICACY; DRUG HALF LIFE; DRUG RESPONSE; DRUG SELECTIVITY; HEART CATHETERIZATION; HEART RIGHT VENTRICLE FAILURE; HEART RIGHT VENTRICLE PRESSURE; HUMAN; LIVER CIRRHOSIS; LIVER TRANSPLANTATION; NONHUMAN; PORTOPULMONARY HYPERTENSION; PRIORITY JOURNAL; PULMONARY HYPERTENSION; REVIEW; SPLENOMEGALY; THROMBOCYTOPENIA; TRANSTHORACIC ECHOCARDIOGRAPHY;

HUMANS; HYPERTENSION, PORTAL; HYPERTENSION, PULMONARY; LIVER CIRRHOSIS; LIVER TRANSPLANTATION; VENTRICULAR DYSFUNCTION, RIGHT;

EID: 77952007671     PISSN: 09527907     EISSN: None     Source Type: Journal    
DOI: 10.1097/ACO.0b013e32833725c4     Document Type: Review

References (33)

1. Afifi S, Shayan S, Al-Qamari A. Pulmonary hypertension and right ventricular •• function: interdependence in pathophysiology and management. Int Anesthesiol Clin 2009;47:97-120. A good review of the pathophysiology of the pulmonary circulation and the effect on right heart function. Importantly, the role of echocardiography in evaluating the right heart is described in detail and the latest therapies described.
2. Ramsay M. Liver transplantation consideration and outcomes for the POPH patient. Adv Pulmon Hypertens 2004;2:9-18.
3. Rodriguez-Roisin R, Krowka M, Hervé P, Fallon M. Pulmonary-hepatic vascular disorders (PHD). Eur Respir J 2004;24:861-880.
4. Kawut SM, Krowka MJ, Trotter JF, et al. Clinical risk factors for portopulmonary •• hypertension. Hepatology 2008;48:196-203. Important review of 536 patients evaluated for liver transplantation in seven centers to identify risk factors for developing PPHTN.
5. Krowka M, Mandell M, Ramsay M, et al. Hepatopulmonary syndrome and portopulmonary hypertension: a report of the multicenter liver transplant database. Liver Transpl 2004;10:174-182. (Pubitemid 38240114)
6. Swanson KL, Wiesner RH, Nyberg SL, et al. Survival in portopulmonary •• hypertension: Mayo Clinic experience categorized by treatment subgroups. Am J Transplant 2008;8:2445-2453. Retrospective review of 74 patients with PPHTN and tracking survival depending on therapy. Those patients who received medical treatment and then LTx had the best outcomes.
7. Roberts KE, Fallong MB, Krowka MD, et al. Genetic risk factors for portopulmonary hypertension in patients with advanced liver disease. Am J Respir Crit Care Med 2009;179:835-842.
8. Roberts KE, Fallon MB, Krowka MJ, et al. Serotonin transporter polymorphisms in patients with portopulmonary hypertension. Chest 2009;135:1470-1475.
9. Swanson KL, Krowka MJ. Screen for portopulmonary hypertension, espe- •• cially in liver transplant candidates. Cleve Clin J Med 2008;75:121-136. An excellent overview of the pathophysiology and screening tools for PPHTN together with available therapies.
10. Kim W, Krowka M, Plevak D, et al. Accuracy of Doppler echocardiography in the assessment of pulmonary hypertension in liver transplant candidates. Liver Transpl 2000;6:453-458.
11. Farzaneh-Far R, McKeown BH, Dang D, et al. Accuracy of Doppler-estimated • pulmonary vascular resistance in patients before liver transplantation. Am J Cardiol 2008;101:259-262. A new technique of using the Doppler TTE to estimate PVR accurately.
12. Ricci GL, Melgosa MT, Burgos F, et al. Assessment of acute pulmonary vascular reactivity in portopulmonary hypertension. Liver Transpl 2007;13:1506-1514.
13. Ramsay M. Liver transplantation and pulmonary hypertension: pathophysiology and management strategies. Curr Opin Organ Transplant 2007;12:274-280.
14. Ramsay M. Portopulmonary hypertension and hepatopulmonary syndrome and liver transplantation. Int Anesthesiol Clin 2006;44:69-82.
15. Le Pavec J, Souza R, Herve P, et al. Portopulmonary hypertension: survival and prognostic factors. Am J Respir Crit Care Med 2008;178:637-643.
16. Ashfaq M, Chinnakotla S, Rodgers L, et al. The impact of treatment of portopulmonary hypertension on survival following liver transplantation. Am J Transpl 2007;7:1258-1264.
17. Fix O, Bass N, De Marco T, Merriman R. Long-term follow-up of portopulmonary hypertension: effect of treatment with epoprostenol. Liver Transpl 2007;13:875-885.
18. Krug S, Sablotzki A, Wirtz H, et al. Inhaled iloprost for the control of pulmonary hypertension. Vasc Health Risk Mgmt 2009;5:465-474.
19. Rex S, Missant C, Claus P, et al. Effects of inhaled iloprost on right ventricular contractility, right ventriculo-vascular coupling and ventricular interdependence: a randomized placebo-controlled trial in an experimental model of acute pulmonary hypertension. Crit Care 2008;12:1-13.
20. Hoeper M, Seyfarth H, Hoeffken G, et al. Experience with inhaled iloprost and bosentan in portopulmonary hypertension. Eur Respir J 2007;30:1096-1102.
21. Naeije R, Huez S. Expert opinion on available options treating pulmonary arterial hypertension. Expert Opin Pharmacother 2007;8:2247-2265.
22. Porres-Aguilar M, Zuckerman M, Figueroa-Casas J, Krowka M. Porto- •• pulmonary hypertension: state of the art. Ann Hepatol 2008;7:321-330. Excellent review of the literature demonstrating that liver transplantation should be considered for those patients who respond optimally to medical therapy.
23. Gough M, White J. Sildenafil therapy is associated with improved hemody- • namics in liver transplantation candidates with pulmonary artery hypertension. Liver Transpl 2009;15:30-36. Small case series demonstrating the efficacy of oral sildenafil in improving hemodynamics in patients with PPHTN.
24. Hemnes A, Robbins I. Sildenafil monotherapy in portopulmonary hypertension can facilitate liver transplantation. Liver Transpl 2009;15:15-19.
25. Tapper E, Knowles D, Heffron T, et al. Portopulmonary hypertension: imatinib as a novel treatment and the Emory experience with this condition. Transpl Proc 2009;1:1969-1971.
26. Koch DG, Caplan M, Reuben A. Pulmonary hypertension after liver trans- •• plantation: case presentation and review of the literature. Liver Transpl 2009;15:407-412. Important review of the literature demonstrating that PHTN may occur after liver transplantation.
27. Sugimachi K, Soejima Y, Morita S, et al. Rapid normalization of portopulmonary hypertension after living donor liver transplantation. Transpl Proc 2009;41:1976-1978.
28. Umeda N, Kamath P. Hepatopulmonary syndrome and portopulmonary hypertension. Hepatol Res 2009;39:1020-1022.
29. Singh C, Sager J. Pulmonary complications of cirrhosis. Med Clin North Am 2009;95:871-883.
30. Yeshua H, Blendis L, Oren R. Pulmonary manifestations of liver diseases. Semin Cardiothorac Vasc Anesth 2009;13:60-69.
31. Golbin J, Krowka M. Portopulmonary hypertension. Clin Chest Med 2007;28:203-218.
32. Krowka M, Fallon M, Mulligan D, et al. Model for end-stage liver disease (MELD) exception for portopulmonary hypertension. Liver Transpl 2006;12:S114-S116. (Pubitemid 44911788)
33. Grannas G, Neipp M, Hoeper M, et al. Indications for and outcomes after • combined lung and liver transplantation: a single center experience on 13 consecutive cases. Transplantation 2008;85:524-531. This is a small case series of combined liver and lung transplant for treating severe PPHTN with reasonable outcomes.