title: [Hepatopulmonary syndrome].
abstract: Hepatopulmonary syndrome (HPS) is defined by the association of portal hypertension, increased alveolar-arterial oxygen gradient and intrapulmonary vascular dilations. Pathophysiological mechanisms of hypoxemia are characterized by ventilation-perfusion mismatch, oxygen diffusion limitation between alveolus and the centre of the dilated capillary, and right-to-left shunting. An excess of vasodilator molecules (like nitric monoxide) and proangiogenic factors (like VEGF) play an important role in the occurrence of HPS. Symptoms of HPS are not specific and dominated by a progressive dyspnea in upright position. Pulse oximetry is a simple non-invasive screening test but only detect the most severe forms of HPS. Medical treatment is disappointing and only liver transplantation may lead to resolution of HPS. Survival following liver transplantation is promising when hypoxemia is not severely decreased.
authors.affiliation: Hôpital universitaire Jean-Minjoz, service d'hépatologie et de soins intensifs digestifs, 25030 Besançon, France. Electronic address: tthevenot@chu-besancon.fr.
authors.forename: Thierry
authors.initials: T
authors.lastname: Thévenot
authors.affiliation: Hôpital universitaire Jean-Minjoz, service d'hépatologie et de soins intensifs digestifs, 25030 Besançon, France.
authors.forename: Delphine
authors.initials: D
authors.lastname: Weil
authors.affiliation: GHPSO - centre hospitalier Laennec, service d'hépato-gastroentérologie et de nutrition, 60109 Creil cedex, France.
authors.forename: Armand
authors.initials: A
authors.lastname: Garioud
authors.affiliation: GHPSO - centre hospitalier Laennec, service d'hépato-gastroentérologie et de nutrition, 60109 Creil cedex, France.
authors.forename: Hortensia
authors.initials: H
authors.lastname: Lison
authors.affiliation: GHPSO - centre hospitalier Laennec, service d'hépato-gastroentérologie et de nutrition, 60109 Creil cedex, France.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Cadranel
authors.affiliation: Hôpital universitaire Jean-Minjoz, service de pneumologie, 25030 Besançon, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Degano
mesh_terms: D020065:Hepatopulmonary Syndrome / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D006801:Humans