Andrius Macas, Aurimas Pečkauskas, Martynas Gedminas, Alina Vilkė, Darius Trepenaitis, Arūnas Gelmanas, Janis Zinkus, Linas Pieteris


The aim of this article is to review pathogenesis, clinical manifestestations, diagnostic and treatment aspects of portopulmonary hypertension. Together with increasing capabilities of transplantology rises the relevance of portopulmonary hypertension. It is estimated, that about 5-8% of liver transplant candidates have this pathologic condition, which greatly increases the risk of perioperative complications and probability of poor outcomes. Only thorough examination of patient‘s pulmonary hemodynamic criteria and the condition of right ventricle can lead to the selection of the optimal treatment. So far, the exact pathogenetic mechanisms of portopulmonary hypertension are not fully understood, but it is known that endothelial dysfunction, domination of vasoconstrictive mediators, vascular remodelation and trombosis play major role in this process. Current treatment regimens used in portopulmonary hypertension are „borrowed“ from algorithms used in pulmonary hypertension of other etiologies, since there aren‘t enough perspective randomised trials available. Most important part in the management of portopulmonary hypertension is vasodilative therapy. Well-timed and proper treatment of this condition may ease the symptoms, increase the overall condition of the patient and even enable successful liver transplantation.

Article in Lithuanian


Keyword(s): portopulmonary hypertension; liver transplantation; pulmonary hypertension; right heart failure; right heart catheterization; vasodilator therapy
DOI: 10.5200/354
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