Hepatopulmonary Syndrome: An Overview

Abstract

The hepatopulmonary syndrome is characterized by a defect in arterial oxygenation induced by pulmonary vascular dilatation in the setting of liver disease. This clinical syndrome has three components: liver disease, pulmonary vascular dilatation, and a defect in oxygenation. Its occurrence has been described in up to 32% of cirrhotic candidates for liver transplantation. The key event in its pathogenesis is the development of intrapulmonary vascular dilatation (IPVD). Even though the clinical symptoms used to identify HPS seem obvious, there is no consensus on strict definitions for each diagnostic criterion. Liver transplantation is considered to be the definitive treatment of hepatopulmonary syndrome with often successful reversal of hypoxemia, however other treatments have been tested. The aim of this review was to review the pathogenesis, current diagnostic criteria and treatment of hepatopulmonary syndrome.