title: [Heptopulmonary syndrome].
abstract: Hepatopulmonary syndrome is characterized by the presence of liver disease, pulmonary vascular dilatations, and arterial hypoxemia. It is usually associated with cirrhosis of any origin, but has been described in other liver diseases, both acute and chronic, and not always associated with portal hypertension. The gold standard method to detect pulmonary vascular dilations is contrast enhancement echocardiography with saline and is essential for the diagnosis of hepatopulmonary syndrome. These dilatations reflect changes in the pulmonary microvasculature (vasodilatation, intravascular monocyte accumulation, and angiogenesis) and induce a ventilation/perfusion mismatch, or even true intrapulmonary shunts, which eventually trigger hypoxemia. This syndrome worsens patients' prognosis and impairs their quality of life and may lead to the need for liver transplantation, which is the only effective and definitive treatment. In this article, we review the etiological, pathophysiological, clinical and therapeutic features of this syndrome.
authors.affiliation: Servicio de Aparato Digestivo, Hospital Universitario Marqués de Valdecilla, Santander, España. Electronic address: aculavin@hotmail.com.
authors.forename: Antonio
authors.initials: A
authors.lastname: Cuadrado
authors.affiliation: Servicio de Aparato Digestivo, Hospital Comarcal de Laredo, Laredo, Cantabria, España.
authors.forename: Ainhoa
authors.initials: A
authors.lastname: Díaz
authors.affiliation: Servicio de Aparato Digestivo, Hospital Universitario Marqués de Valdecilla, Santander, España.
authors.forename: Paula
authors.initials: P
authors.lastname: Iruzubieta
authors.affiliation: Servicio de Aparato Digestivo, Hospital Comarcal de Laredo, Laredo, Cantabria, España.
authors.forename: José Ramón
authors.initials: JR
authors.lastname: Salcines
authors.affiliation: Servicio de Aparato Digestivo, Hospital Universitario Marqués de Valdecilla, Santander, España.
authors.forename: Javier
authors.initials: J
authors.lastname: Crespo
mesh_terms: D001784:Blood Gas Analysis; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D004452:Echocardiography / Q000379:methods; D020065:Hepatopulmonary Syndrome / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications / Q000503:physiopathology; D000860:Hypoxia / Q000209:etiology; D008107:Liver Diseases / Q000150:complications / Q000503:physiopathology; D016031:Liver Transplantation; D010102:Oxygen Inhalation Therapy; D011379:Prognosis; D011652:Pulmonary Circulation; D011788:Quality of Life; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin; D014664:Vasodilation
chemical_list: D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin
keywords: Cirrhosis; Cirrosis; Contrast enhancement echocardiography; Ecocardiografía con realce de contraste de salino; HPS; Hepatopulmonary syndrome; Hipoxemia; Hypoxemia; Liver transplantation; SHP; Síndrome hepatopulmonar; Trasplante hepático