TITLE:
Portopulmonary Hypertension in Patients Undergoing Liver Transplantation: A Case Report
AUTHORS:
Emica Shimozono, Cristina A. A. Caruy, Adilson R. Cardoso, Ilka F. S. F. Boin
KEYWORDS:
Portopulmonary Hypertension; Portal Hypertension; Survival; Liver Transplantation
JOURNAL NAME:
Surgical Science,
Vol.5 No.2,
February
7,
2014
ABSTRACT: Portopulmonary
hypertension (PPH) is a form of pulmonary arterial hypertension, characterized
by elevation of pulmonary arterial pressure due to increased resistance to
pulmonary blood flow. It is a consequence of portal hypertension, associated or
not with liver disease. A retrospective study of patients undergoing liver
transplantation was carried out in the Liver Transplantation Unit of the
Clinics Hospital of the State University of Campinas (UNICAMP) from 1991 to
2012, covering 389 transplants. Although 50 (12.9%) patients presented with
mean pulmonary arterial pressure (MPAP) > 25 mmHg, only one case (0.25%) met
the diagnostic criteria for PPH: a 43-year-old female patient with advanced
liver disease, caused by primary biliary cirrhosis with portal hypertension,
diagnosed as mild portopulmonary hypertension and diagnosed in the operating
room. PPH is a serious complication of portal hypertension. It is related to
the great difficulty in diagnosis and the high mortality rate due to right heart
failure. PPH is an entity with a low frequency of occurrence in individuals
undergoing liver transplantation, although there is a wide variation in the
prevalence rate presented in the literature and the definitive diagnosis should
be confirmed with right heart catheterization.