The use of sildenafil to treat portopulmonary hypertension prior to liver transplantation.
Portopulmonary hypertension (PPH) is an infrequent, but well-recognized complication of liver cirrhosis. PPH in those with end-stage liver disease has a significant impact on per-operative and intra-operative mortality, with liver transplantation being contraindicated in those individuals with mean pulmonary artery pressure exceeding 50 mmHg. Vasodilatory therapy is the mainstay of pharmacotherapy for PPH, although the evidence of benefit is largely extrapolated from the pulmonary hypertension literature. We report the use of the phosphodiesterase inhibitor, sildenafil, in a patient with end stage liver disease and PPH, with a pulmonary artery pressure before transplantation of 75 mmHg, to reduce pulmonary artery pressure prior to a successful liver transplant.
Cadden
Ian S H
IS
Department of Gastroenterology.
Greanya
Erica D
ED
Erb
Siegfried R
SR
Scudamore
Charles H
CH
Yoshida
Eric M
EM
D000959:Antihypertensive Agents / Q000627:therapeutic use*; D004932:Esophageal and Gastric Varices / Q000209:etiology / Q000601:surgery; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000601:surgery; D006526:Hepatitis C / Q000150:complications / Q000188:drug therapy / Q000601:surgery*; D006801:Humans; D006975:Hypertension, Portal / Q000188:drug therapy* / Q000209:etiology; D006976:Hypertension, Pulmonary / Q000188:drug therapy* / Q000209:etiology; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000627:therapeutic use*; D011687:Purines / Q000627:therapeutic use; D000068677:Sildenafil Citrate; D013450:Sulfones / Q000627:therapeutic use*; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000627:therapeutic use*
D000959:Antihypertensive Agents; D010879:Piperazines; D011687:Purines; D013450:Sulfones; D014665:Vasodilator Agents; D000068677:Sildenafil Citrate