Pulmonary Complications of the Liver

Hepatic hydrothorax (HH), hepatopulmonary syndrome (HPS), and portopulmonary hypertension (PoPH) are the most common complications of portal hypertension. In this review we will discuss the most relevant aspects regarding its diagnosis and treatment.

Pulmonary complications of the liver are associated with a detrimental quality of life and decreased survival. HH can be reported in up to 15% of patients with cirrhosis and it is usually associated with ascites. HPS and PoPH are severe pulmonary vascular complications of portal hypertension and they are not associated with neither the severity of portal hypertension nor the etiology of liver disease. Patients with prompt screening of these complications can benefit with timely treatment and eventually, liver transplantation.

Liver transplantation is the ultimate treatment to resolve HH, HPS, and PoPH. However, the post-transplant course of PoPH can be challenging and patients might still require indefinitely vasomodulatory therapies.