title: Pulmonary complications in cirrhosis.
abstract: OBJECTIVE
  To summarize the pulmonary complications seen in cirrhosis.
  
  
  RESULTS
  The definition of portopulmonary hypertension (POPH) has been refined to exclude cardiac disease. POPH may be treated with a variety of agents; inhaled agents are particularly useful in the peri-transplant period. Hepatopulmonary syndrome (HPS) remains refractory to medical therapy.
  
  
  CONCLUSIONS
  Cirrhosis may be complicated by one of two pulmonary vascular complications, portopulmonary hypertension (POPH) and hepatopulmonary syndrome (HPS). POPH is a syndrome of increased vascular resistance, initiated by pulmonary vascular spasm. HPS is caused by intrapulmonary arteriovenous shunting with resultant hypoxemia. Both conditions are associated with portal hypertension, but are unrelated to the degree of portal hypertension, the nature or severity of the liver disease, and are associated with mortality in excess of the model for end-stage liver disease score. POPH is usually responsive to vasodilators, while HPS remains resistant to therapeutic agents. Both conditions are improved or cured by liver transplantation.
authors.affiliation: Baylor College of Medicine, Houston, Texas 77030, USA. normans@bcm.edu
authors.forename: Norman L
authors.initials: NL
authors.lastname: Sussman
authors.forename: Rajan
authors.initials: R
authors.lastname: Kochar
authors.forename: Michael B
authors.initials: MB
authors.lastname: Fallon
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use; D006439:Hemodynamics; D020065:Hepatopulmonary Syndrome / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D006976:Hypertension, Pulmonary / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D008103:Liver Cirrhosis / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D016031:Liver Transplantation; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000627:therapeutic use
chemical_list: D000959:Antihypertensive Agents; D014665:Vasodilator Agents