Abstract
Hepatopulmonary syndrome and portopulmonary hypertension are complications of portal hypertension with opposing mechanisms that can coexist. Moderate portopulmonary hypertension, which is a contraindication to a liver transplant, must be managed with pulmonary vasodilators to normalize pulmonary arterial pressures before a transplant listing. Concomitant hepatopulmonary syndrome complicates the management of portopulmonary hypertension, as pulmonary vasodilators can theoretically exacerbate the intrapulmonary dilatation believed to cause hepatopulmonary syndrome. We describe a case of a post-liver transplant patient with concomitant hepatopulmonary syndrome and portopulmonary hypertension safely treated with sildenafil.
MeSH terms
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Antihypertensive Agents / adverse effects
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Antihypertensive Agents / therapeutic use*
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Female
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Hemodynamics / drug effects*
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Hepatopulmonary Syndrome / diagnosis
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Hepatopulmonary Syndrome / etiology
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Hepatopulmonary Syndrome / physiopathology
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Hepatopulmonary Syndrome / surgery*
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Humans
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Hypertension, Portal / diagnosis
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Hypertension, Portal / drug therapy*
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Hypertension, Portal / etiology
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Hypertension, Portal / physiopathology
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Hypertension, Pulmonary / diagnosis
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Hypertension, Pulmonary / drug therapy*
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Hypertension, Pulmonary / etiology
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Hypertension, Pulmonary / physiopathology
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Liver Circulation / drug effects
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Liver Transplantation / adverse effects*
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Middle Aged
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Pulmonary Circulation / drug effects
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Sildenafil Citrate / adverse effects
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Sildenafil Citrate / therapeutic use*
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Treatment Outcome
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Vasodilator Agents / adverse effects
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Vasodilator Agents / therapeutic use*
Substances
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Antihypertensive Agents
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Vasodilator Agents
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Sildenafil Citrate