Abstract
Hepatopulmonary syndrome (HPS) is a disease of gas exchange caused by intrapulmonary shunting secondary to liver disease-associated intrapulmonary vascular dilation [1]. HPS is characterized by the triad of arterial deoxygenation, intrapulmonary vascular dilatation, and liver disease, all of which occur in the absence of a primary cardiopulmonary anomaly. Liver diseases that are commonly involved include cirrhosis, portal hypertension, and portosystemic shunt [2]. HPS is not correlated with cirrhosis severity and can be caused even by asymptomatic cirrhosis [3]. HPS may also develop in noncirrhotic portal hypertension [4].
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Rodriquez-Roisin R, et al. Highlights of the ERS Task Force on pulmonary-hepatic vascular disorders (PHD). J Hepatol. 2005;42(6):924–7.
Rodriguez-Roisin R, Krowka MJ. Hepatopulmonary syndrome—a liver-induced lung vascular disorder. N Engl J Med. 2008;358(22):2378–87.
Krowka MJ, et al. International liver transplant society practice guidelines: diagnosis and management of hepatopulmonary syndrome and portopulmonary hypertension. Transplantation. 2016;100(7):1440–52.
Kaymakoglu S, et al. Hepatopulmonary syndrome in noncirrhotic portal hypertensive patients. Dig Dis Sci. 2003;48(3):556–60.
Okazaki T, et al. Long-term postsurgical outcome of biliary atresia. J Pediatr Surg. 1999;34(2):312–5.
Castro M, Krowka MJ. Hepatopulmonary syndrome. A pulmonary vascular complication of liver disease. Clin Chest Med. 1996;17(1):35–48.
Ogawa E, et al. Living-donor liver transplantation for congenital biliary atresia with porto-pulmonary hypertension and moderate or severe pulmonary arterial hypertension: Kyoto University experience. Clin Transpl. 2014;28(9):1031–40.
Umeda A, et al. Hepatopulmonary syndrome can show spontaneous resolution: possible mechanism of portopulmonary hypertension overlap? Respirology. 2006;11(1):120–3.
Urashima Y, et al. Living related liver transplantation for biliary atresia with portopulmonary hypertension: case report. Transplant Proc. 2004;36(8):2237–8.
Sasaki T, et al. Development of intrapulmonary arteriovenous shunting in postoperative biliary atresia: evaluation by contrast-enhanced echocardiography. J Pediatr Surg. 2000;35(11):1647–50.
Soh H, et al. Pulmonary hypertension associated with postoperative biliary atresia: report of two cases. J Pediatr Surg. 1999;34(12):1779–81.
Fallon MB, et al. Impact of hepatopulmonary syndrome on quality of life and survival in liver transplant candidates. Gastroenterology. 2008;135(4):1168–75.
Schraufnagel DE, Kay JM. Structural and pathologic changes in the lung vasculature in chronic liver disease. Clin Chest Med. 1996;17(1):1–15.
Rolla G, et al. Exhaled nitric oxide and impaired oxygenation in cirrhotic patients before and after liver transplantation. Ann Intern Med. 1998;129(5):375–8.
Matsumoto H, et al. Clinical significance of plasma endothelin-1 in patients with chronic liver disease. Dig Dis Sci. 1994;39(12):2665–70.
Uchihara M, et al. Clinical significance of elevated plasma endothelin concentration in patients with cirrhosis. Hepatology. 1992;16(1):95–9.
Hasegawa T, et al. Plasma endothelin-1 level as a marker reflecting the severity of portal hypertension in biliary atresia. J Pediatr Surg. 2001;36(11):1609–12.
Fallon MB, et al. The role of endothelial nitric oxide synthase in the pathogenesis of a rat model of hepatopulmonary syndrome. Gastroenterology. 1997;113(2):606–14.
Luo B, et al. ET-1 and TNF-alpha in HPS: analysis in prehepatic portal hypertension and biliary and nonbiliary cirrhosis in rats. Am J Physiol Gastrointest Liver Physiol. 2004;286(2):G294–303.
Ling Y, et al. The role of endothelin-1 and the endothelin B receptor in the pathogenesis of hepatopulmonary syndrome in the rat. Hepatology. 2004;39(6):1593–602.
Rabiller A, et al. Prevention of gram-negative translocation reduces the severity of hepatopulmonary syndrome. Am J Respir Crit Care Med. 2002;166(4):514–7.
Zhang J, et al. Pulmonary angiogenesis in a rat model of hepatopulmonary syndrome. Gastroenterology. 2009;136(3):1070–80.
Mal H, et al. Pulmonary hypertension following hepatopulmonary syndrome in a patient with cirrhosis. J Hepatol. 1999;31(2):360–4.
Palma DT, et al. Oxygen desaturation during sleep in hepatopulmonary syndrome. Hepatology. 2008;47(4):1257–63.
McAdams HP, et al. The hepatopulmonary syndrome: radiologic findings in 10 patients. AJR Am J Roentgenol. 1996;166(6):1379–85.
Martinez GP, et al. Hepatopulmonary syndrome in candidates for liver transplantation. J Hepatol. 2001;34(5):651–7.
Borkar VV, et al. Hepatopulmonary Syndrome in children: a comparative study of non-cirrhotic vs. cirrhotic portal hypertension. Liver Int. 2015;35(6):1665–72.
Rodriguez-Roisin R, et al. Pulmonary-Hepatic vascular Disorders (PHD). Eur Respir J. 2004;24(5):861–80.
Schenk P, et al. Hepatopulmonary syndrome: prevalence and predictive value of various cut offs for arterial oxygenation and their clinical consequences. Gut. 2002;51(6):853–9.
Palma DT, Fallon MB. The hepatopulmonary syndrome. J Hepatol. 2006;45(4):617–25.
Arguedas MR, et al. Utility of pulse oximetry screening for hepatopulmonary syndrome. Clin Gastroenterol Hepatol. 2007;5(6):749–54.
Kochar R, Tanikella R, Fallon MB. Serial pulse oximetry in hepatopulmonary syndrome. Dig Dis Sci. 2011;56(6):1862–8.
Warner S, et al. Hepatopulmonary syndrome in children: a 20-year review of presenting symptoms, clinical progression, and transplant outcome. Liver Transpl. 2018;24(9):1271–9.
Raevens S, et al. Hepatopulmonary syndrome and portopulmonary hypertension: recent knowledge in pathogenesis and overview of clinical assessment. Liver Int. 2015;35(6):1646–60.
Abrams GA, et al. Diagnostic utility of contrast echocardiography and lung perfusion scan in patients with hepatopulmonary syndrome. Gastroenterology. 1995;109(4):1283–8.
Wolfe JD, et al. Hypoxemia of cirrhosis: detection of abnormal small pulmonary vascular channels by a quantitative radionuclide method. Am J Med. 1977;63(5):746–54.
Abrams GA, et al. Use of macroaggregated albumin lung perfusion scan to diagnose hepatopulmonary syndrome: a new approach. Gastroenterology. 1998;114(2):305–10.
Krowka MJ, et al. Hepatopulmonary syndrome: a prospective study of relationships between severity of liver disease, PaO(2) response to 100% oxygen, and brain uptake after (99m)Tc MAA lung scanning. Chest. 2000;118(3):615–24.
Arguedas MR, et al. Prospective evaluation of outcomes and predictors of mortality in patients with hepatopulmonary syndrome undergoing liver transplantation. Hepatology. 2003;37(1):192–7.
Roberts DN, Arguedas MR, Fallon MB. Cost-effectiveness of screening for hepatopulmonary syndrome in liver transplant candidates. Liver Transpl. 2007;13(2):206–14.
Ueno T, et al. Onset ages of hepatopulmonary syndrome and pulmonary hypertension in patients with biliary atresia. Pediatr Surg Int. 2017;33(10):1053–7.
Abrams GA, Fallon MB. The hepatopulmonary syndrome. Clin Liver Dis. 1997;1(1):185–200. xiii
Gupta S, et al. Improved survival after liver transplantation in patients with hepatopulmonary syndrome. Am J Transplant. 2010;10(2):354–63.
Swanson KL, Wiesner RH, Krowka MJ. Natural history of hepatopulmonary syndrome: impact of liver transplantation. Hepatology. 2005;41(5):1122–9.
Swanson KL, et al. Survival in portopulmonary hypertension: Mayo Clinic experience categorized by treatment subgroups. Am J Transplant. 2008;8(11):2445–53.
Iyer VN, et al. Hepatopulmonary syndrome: favorable outcomes in the MELD exception era. Hepatology. 2013;57(6):2427–35.
Hirata Y, et al. Outcomes of 50 cases of pediatric liver transplantation for intrapulmonary shunt while considering the deteriorated prognosis of severe intrapulmonary shunt patients. Transplant Proc. 2019;51(8):2793–7.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2021 The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
About this chapter
Cite this chapter
Ueno, T. (2021). Long-Term Complications: Hepatopulmonary Syndrome. In: Nio, M. (eds) Introduction to Biliary Atresia. Springer, Singapore. https://doi.org/10.1007/978-981-16-2160-4_35
Download citation
DOI: https://doi.org/10.1007/978-981-16-2160-4_35
Published:
Publisher Name: Springer, Singapore
Print ISBN: 978-981-16-2159-8
Online ISBN: 978-981-16-2160-4
eBook Packages: MedicineMedicine (R0)