title: Hepatopulmonary Syndrome and Liver Transplantation: A Recent Review of the Literature.
abstract: A severe and common pulmonary vascular complication of liver disease is hepatopulmonary syndrome (HPS). It is a triad of liver dysfunction and/or portal hypertension, intrapulmonary vascular dilatations, and increased alveolar-arterial oxygen gradient. Prevalence varies according to various study groups from 4%-47%. While the most common presenting symptom of HPS is dyspnea, it is usually asymptomatic, and thus all liver transplant candidates should be screened for its presence. Pulse oximetry is a useful screening method, but arterial blood gas examination is the gold standard. If there is an abnormal P (A-a)O2 gradient, microbubble transthoracic echocardiography should be done for diagnosis. Outcome is unpredictable, and there is currently no effective medical therapy. The only effective therapy is considered to be liver transplantation. Complete resolution of HPS after liver transplantation is seen within a year in most HPS patients.
authors.affiliation: Johns Hopkins University School of Medicine, Department of Gastroenterology/Hepatology, Baltimore, MD, USA.
authors.forename: Caglar
authors.initials: C
authors.lastname: Cosarderelioglu
authors.affiliation: Johns Hopkins University School of Medicine, Department of Gastroenterology/Hepatology, Baltimore, MD, USA.
authors.forename: Arif M
authors.initials: AM
authors.lastname: Cosar
authors.affiliation: Virginia Commonwealth University School of Medicine, Richmond, VA, USA.
authors.forename: Merve
authors.initials: M
authors.lastname: Gurakar
authors.affiliation: Johns Hopkins University School of Medicine, Department of Surgery/Liver Transplant, Baltimore, MD, USA.
authors.forename: Nabil N
authors.initials: NN
authors.lastname: Dagher
authors.affiliation: Johns Hopkins University School of Medicine, Department of Gastroenterology/Hepatology, Baltimore, MD, USA.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Gurakar
keywords: Hepatopulmonary syndrome; Liver transplantation; Pulmonary complications of cirrhosis