Pulmonary Vascular Complications in Liver Disease: A Comprehensive Review of Porto-Pulmonary Hypertension and HepatopulmonarySyndrome with Illustrative Case Studies

Authors

  • Ritesh Bhandari Department of Gastroenterology, Alice Springs Hospital, Alice Springs, Northern Territory, Australia Author
  • Muhammad M Javaid Monash Rural Health Mildura, Monash University, Victoria, Australia Author
  • Jack Shembrey Department of Infectious Disease, Alice Springs Hospital, Alice Springs, Northern Territory, Australia Author
  • Pratima Gurung Department of General Medicine, Nepean Hospital, Kingswood, NSW, Australia Author
  • Adel Ekladious Department of General Medicine and Acute Assessment Unit, Canberra Hospital, Canberra, ACT, Australia Author

DOI:

https://doi.org/10.47363/JGHR/2024(5)171

Keywords:

Porto Pulmonary Hypertension, Hepatopulmonary Syndrome, Liver Cirrhosis, Pulmonary Hypertension, Liver Transplantation

Abstract

Background: Porto-pulmonary hypertension (PoPH) and hepatopulmonary syndrome (HPS) are significant pulmonary vascular complications in liver disease patients. Understanding their distinct features is crucial for optimal care.


Objectives: To provide an updated overview of PoPH and HPS, compare these conditions, and highlight diagnostic and treatment challenges using
illustrative case studies.


Methods: A comprehensive literature review was conducted using PubMed, Embase, and Cochrane databases. Two case studies illustrate key clinical features and management considerations.


Results: Orthotopic liver transplantation (OLT) generally improves outcomes more consistently in HPS than in PoPH. Appropriate bridging therapy can significantly improve PoPH prognosis prior to OLT. Case studies highlight these approaches, including an atypical HPS presentation with acute liver injury, Budd-Chiari syndrome, and portal hypertension without pre-existing cirrhosis.


Conclusion: PoPH and HPS present distinct challenges in liver disease. Early recognition, accurate diagnosis, and tailored management strategies are crucial for improving outcomes. Clinicians must maintain a high index of suspicion for these complications, even in atypical presentations, to ensure timely diagnosis and optimal management.

Author Biographies

  • Ritesh Bhandari, Department of Gastroenterology, Alice Springs Hospital, Alice Springs, Northern Territory, Australia

    Department of Gastroenterology, Alice Springs Hospital, Alice Springs, Northern Territory, Australia

  • Muhammad M Javaid, Monash Rural Health Mildura, Monash University, Victoria, Australia

    Monash Rural Health Mildura, Monash University, Victoria, Australia

  • Jack Shembrey, Department of Infectious Disease, Alice Springs Hospital, Alice Springs, Northern Territory, Australia

    Department of Infectious Disease, Alice Springs Hospital, Alice Springs, Northern Territory, Australia

  • Pratima Gurung, Department of General Medicine, Nepean Hospital, Kingswood, NSW, Australia

    Department of General Medicine, Nepean Hospital, Kingswood, NSW, Australia

  • Adel Ekladious, Department of General Medicine and Acute Assessment Unit, Canberra Hospital, Canberra, ACT, Australia

    Department of General Medicine and Acute Assessment Unit, Canberra Hospital, Canberra, ACT, Australia

Downloads

Published

2024-12-24

Issue

Vol. 5 No. 6 (2024): Volume 5 Issue 6

Section

Articles