title: Response to Sildenafil in a Patient With Coexisting Post-Liver Transplant Portopulmonary Hypertension and Hepatopulmonary Syndrome.
abstract: Hepatopulmonary syndrome and portopulmonary hypertension are complications of portal hypertension with opposing mechanisms that can coexist. Moderate portopulmonary hypertension, which is a contraindication to a liver transplant, must be managed with pulmonary vasodilators to normalize pulmonary arterial pressures before a transplant listing. Concomitant hepatopulmonary syndrome complicates the management of portopulmonary hypertension, as pulmonary vasodilators can theoretically exacerbate the intrapulmonary dilatation believed to cause hepatopulmonary syndrome. We describe a case of a post-liver transplant patient with concomitant hepatopulmonary syndrome and portopulmonary hypertension safely treated with sildenafil.
authors.affiliation: rom the Department of Pharmacy, Vancouver General Hospital, Vancouver, Canada.
authors.forename: Ricky D
authors.initials: RD
authors.lastname: Turgeon
authors.forename: Trana
authors.initials: T
authors.lastname: Hussaini
authors.forename: Nilufar
authors.initials: N
authors.lastname: Partovi
authors.forename: Siegfried R
authors.initials: SR
authors.lastname: Erb
authors.forename: Roland
authors.initials: R
authors.lastname: Nador
authors.forename: Vladimir
authors.initials: V
authors.lastname: Marquez Azalgara
authors.forename: Eric
authors.initials: E
authors.lastname: Yoshida
mesh_terms: D000959:Antihypertensive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006439:Hemodynamics / Q000187:drug effects*; D020065:Hepatopulmonary Syndrome / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; 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; D008102:Liver Circulation / Q000187:drug effects; D016031:Liver Transplantation / Q000009:adverse effects*; D008875:Middle Aged; D011652:Pulmonary Circulation / Q000187:drug effects; D000068677:Sildenafil Citrate / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D000959:Antihypertensive Agents; D014665:Vasodilator Agents; D000068677:Sildenafil Citrate