title: Pulmonary hypertension in liver transplant.
abstract: OBJECTIVE
  Pulmonary hypertension patients provide challenging issues to anesthesiology. The condition is more so when it is associated with liver transplant surgery. This situation is especially true when associated with portopulmonary hypertension (POPH), a subdivision of pulmonary hypertension. Understanding the disease process as well as treatment outcome is an important factor for intraoperative management of those patients.
  
  
  RESULTS
  Though offering many challenges, mild-to-moderate pulmonary hypertension and POPH patients could be transplanted safely. The most recently published studies describe the mortality of liver transplant patients with severe pulmonary hypertension and POPH to be 100%. The only available option might be a combined liver-lung transplant surgery, an option limited to very few centers.
  
  
  CONCLUSIONS
  Publication on intraoperative anesthetic management of patient with pulmonary hypertension and POPH during liver transplant remains sparse. Management requires experience in cardiovascular anesthesia and utilization of knowledge, skills, medications, and tools learned in such cases. Further studies should be conducted on intraoperative use of inhaled and intravenous pulmonary vasodilators for its potential benefits during liver transplant surgery.
authors.affiliation: Department of Clinical Anesthesiology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA. tayoub@usc.edu
authors.forename: Tawfik
authors.initials: T
authors.lastname: Ayoub
mesh_terms: D000768:Anesthesia, General / Q000009:adverse effects; D006439:Hemodynamics; D006801:Humans; D006975:Hypertension, Portal / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D006976:Hypertension, Pulmonary / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D007430:Intraoperative Care; D008107:Liver Diseases / Q000150:complications / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects; D018579:Patient Selection; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000008:administration & dosage
chemical_list: D014665:Vasodilator Agents