Portopulmonary hypertension: diagnosis and preoperative management.

IF 2.1

Current opinion in anaesthesiology Pub Date : 2025-08-01 Epub Date: 2025-06-24 DOI:10.1097/ACO.0000000000001527

David W Wang, Akira Katayama, Marianne M Ligon, Ezeldeen Abuelkasem

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Abstract

Purpose of review: Preoperative management of portopulmonary hypertension (PoPH) has been difficult to establish because the prevalence of PoPH is relatively low. In recent years, however, several studies have provided new insights into this area. This review outlines the diagnosis and preoperative management of PoPH in light of the latest findings.

Recent findings: In a recent retrospective study including 723 patients who underwent liver transplantation, preoperative evaluation of right ventricular systolic pressure on transthoracic echocardiography (TTE) was well correlated with mean pulmonary arterial pressure on right heart catheterization (RHC). TTE can play an important role for screening patients with a higher likelihood of pulmonary hypertension before undergoing more invasive diagnostic testing with RHC.

Summary: Liver transplantation for patients with irreversible PoPH is contraindicated. Early diagnosis and appropriate therapeutic interventions in patients with PoPH are crucial to prevent disease progression and improve patient prognosis.

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门脉性肺动脉高压：诊断与术前处理。

回顾目的：由于门脉肺动脉高压（PoPH）的患病率相对较低，因此术前管理一直难以确定。然而，近年来，一些研究为这一领域提供了新的见解。本文综述了根据最新发现的PoPH的诊断和术前管理。最近发现：在一项包括723例肝移植患者的回顾性研究中，经胸超声心动图（TTE）的术前右心室收缩压评估与右心导管（RHC）的平均肺动脉压有很好的相关性。TTE在进行更有创性的RHC诊断检测之前，可在筛查肺动脉高压可能性较高的患者中发挥重要作用。总结：肝移植是不可逆PoPH患者的禁忌症。PoPH患者的早期诊断和适当的治疗干预对于预防疾病进展和改善患者预后至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Current opinion in anaesthesiology

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