Current concepts in the management of hepatopulmonary syndrome.
The hepatopulmonary syndrome is characterized as the triad of liver disease, pulmonary gas exchange abnormalities leading to arterial deoxygenation and evidence of intrapulmonary vascular dilatations. This review summarizes the pathological mechanisms leading to pulmonary vascular changes in hepatopulmonary syndrome. The role of the three currently used diagnostic imaging modalities of contrast-enhanced echocardiography, perfusion lung scanning and pulmonary arteriography that identify the presence of intrapulmonary vascular abnormalities are reviewed. Liver transplantation is considered to be the definitive treatment of hepatopulmonary syndrome with often successful reversal of hypoxemia, however other treatments have been trialed. This review further appraises the evidence for the use of pharmacological agents and the role of radiological interventions in hepatopulmonary syndrome.
Ho
Vincent
V
School of Medicine, James Cook University, Cairns, Queensland, Australia. vincent_ho@health.qld.gov.au
D002317:Cardiovascular Agents / Q000627:therapeutic use; D018450:Disease Progression; D020065:Hepatopulmonary Syndrome / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D006801:Humans; D000860:Hypoxia / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D016031:Liver Transplantation; D019168:Portasystemic Shunt, Transjugular Intrahepatic; D011651:Pulmonary Artery / Q000503:physiopathology*; D015641:Radiography, Interventional; D016896:Treatment Outcome; D014664:Vasodilation
D002317:Cardiovascular Agents