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Revista de la Asociación Médica del Centro Médico ABC

2006, Number 3

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An Med Asoc Med Hosp ABC 2006; 51 (3)

The hepatopulmonary syndrome

Martínez LE, Jiménez ZVH, Gallardo ALA, Álvarez MI

Language: Spanish
References: 91
Page: 124-133
PDF size: 112.94 Kb.


ABSTRACT

Pulmonary disease manifestations of liver failure may include pulmonary hypertension, acute lung injury, restrictive or obstructive diseases, interstitial fibrosis, pleural effusion and various impairments of pulmonary gas exchange, of which the hepatopulmonary syndrome is one entity. Hepatopulmonary syndrome (HPS) is a disease entity that is seen in association with liver failure and is one of the many extrahepatic manifestations of liver failure, with a reported incidence of 13 to 47%. Using Chang’s animal model Fallon and colleagues opened a new dimension into the current understanding of hepatopulmonary syndrome. While we await further evidence of the molecular biology of the syndrome, Orthotopic liver trasplantation remains the only therapy for this disease.


REFERENCES

  1. Budhijara R, Hassoun AP. Portopulmonary hypertension a tale of two circulations. Chest 2003; 123 (2): 201-228.

  2. Scott V, Forrest Dodson S, Kang Y. The hepatopulmonary syndrome. Surg Clin N Am 1999; 23-42.

  3. Hopkins WE, Waggoner AD, Brazilai B. Frequency and significance of intrapulmonary right-to left shunting in end stage hepatic disease. Am J Card 1992; 70: 516-519.

  4. Hourani JM, Bellamy PE, Tashkin DP et al. Pulmonary dysfunction in advanced liver disease: Frequent occurrence of an abnormal diffusing capacity. Am J Med 1991; 90: 693-700.

  5. Genovesi MG, Tierney DF, Taplan GV et al. An intravenous radionuclide method to evaluate hyperemia caused by abnormal alveolar vessels: Limitations of conventional techniques. Am Rev Respir Dis 1976; 114: 59.

  6. Castro M, Krowka MJ. Hepatopulmonary syndrome: A pulmonary vascular complication of liver disease. Clin Chest Med 1996; 17: 35-48.

  7. Williams A, Trewby P, Williams R, et al. Structural alterations to the pulmonary circulation in fulminant hepatic failure. Thorax 1979; 34: 4453-4476.

  8. Krowka MJ, Tajik AJ, Dickson ER et al. Intrapulmonary vascular dilatations (IPVD) in liver transplant candidates: Screening by two dimensional contrast enhanced echocardiography. Chest 1990; 97: 1165-1170.

  9. Abrams GA, Jaffe CC, Hoffer PE et al. Diagnostic utility of contrast echocardiography and lung perfusion scan in patients with hepatopulmonary syndrome. Gastroenterology 1995; 109: 1283-1288.

  10. Abrams GA, Nanda NC, Dubovsky EV et al. Use of macroaggregated albumin lung perfusion scan to diagnose hepatopulmonary syndrome: A new approach. Gastroenterology 1998; 114: 305-310.

  11. Kennedy TC, Knudson RJ. Exercise aggravated hypoxemia and orthodeoxia in cirrhosis. Chest 1977; 72: 305-309.

  12. Fluckiger M, Vorkommen von Trommelschlagelformigen Finger und Phalanger ohne chroniseche Veranderunger an den Lungen oder am Herzen. (Abstract). Wien Med Wocheschr 1984; 34: 1457.

  13. Rydell R, Hoffbauer FW. Multiple pulmonary arteriovenous fistulas in juvenile cirrhosis. Am J Med 1956; 21: 450-460.

  14. Krowka MJ, Cortese DA. Hepatopulmonary syndrome. Current concepts in diagnostic and therapeutic considerations. Chest 1994; 105: 1528-1537.

  15. Rodriguez-Roisin R, Roca J. Hepatopulmonary syndrome. The paradigm of liver induced hypoxemia. Ballieres Clin Gastroenterol 1997; 11: 387-406.

  16. Krowka MJ, Dickson ER, Cortese DA. Hepatopulmonary syndrome: Clinical observations and lack of therapeutic response to somatostatin analogue. Chest 1993; 104: 515-521.

  17. De Oliveira ML, Moraes MF , Pinheiro MA et al. Hepatopulmonary syndrome. Acta Med Port 1997; 10: 844-848.

  18. Rodriguez-Roisin R, Agusti AG, Roca R. The hepatopulmonary syndrome: New name, old complexities. Thorax 1992; 47: 897-902.

  19. Krowka MJ, Cortese DA. Hepatopulmonary syndrome: An envolving perspective in the era of liver trasplantation. Hepatology 1990; 11: 138-142.

  20. Kaspar MD, Ramsay MA, Shuey CB Jr et al. Severe pulmonary hypertension and amelioration of hepatopulmonary syndrome after liver trasplantation. Liver Trasp Surg 1998; 4: 177-179.

  21. Al-Moamary M, Altraif I. Hepatopulmonary syndrome associated with schistosomal liver disease. Can J Gastroenterol 1997; 11: 449-50.

  22. Deviere J, Brohee D, Hiden M et al. Hepatic telangiestasia and cirrhosis . J Clin Gastroenterology 1988; 10: 111-114.

  23. Srivastava SC. Hepatopulmonary amebiasis. J Assoc Physicians India 1991; 39: 725.

  24. Vickers PJ, Bohra RC, Sharma GC. Hepatopulmonary amebiasis– a review of 40 cases. Int Surg 1982; 67: 427-429.

  25. Volkova KI, Bizhanov BA, Nurpeisov AZ et al. A rare case of alveolar echinococcosis of the lungs and liver complicated by hepatopulmonary fistula. Klin Med 1995; 73: 55-57.

  26. Krowka MJ. Clinical management of hepatopulmonary syndrome. Semin Liver Dis 1993; 13: 414-422.

  27. Schwarzenberg SJ, Freese DK, Reglemann WE et al. Resolution of severe intrapulmonary shunting after liver trasplantation. Chest 1993; 103: 1271.

  28. Scott V, Miro A, Kang Y et al. Reversibility of the hepatopulmonary syndrome by orthotopic liver trasplantation. Tras Proc 1993; 25: 1787-1788.

  29. Caruso G, Catalano D. Esophageal varices and hepatopulmonary syndrome in liver cirrhosis. J Hematol 1991; 12: 262-263.

  30. Hales MR. Multiple small arteriovenous fistulae of the lungs. Am J Pathol 1956; 32: 927.

  31. Mellemgaard K, Winkler K, Tygstrup N et al. Sources of venoarterial admixture in portal hypertension. J Clin Invest 1963; 42: 1399-1405.

  32. Schraufnagel DE, Pearse DB, Mitzner WA et al. Three dimensional structure of the bronchial microcirculation in sheep. Anat Rec 1995; 243: 357.

  33. Schrafnagel DE, Malik R, Goel V et al. Lung capillary changes in hepatic cirrhosis rats. Am J Physiol 1997; 272: 139-147.

  34. Schraufnagel DE, Kay JM. Structural and pathologic changes in the lung vasculature in chronic liver disease. Clin Chest Med 1996; 17: 1-13.

  35. Chiesa A, Ciappi G, Baldii L et al. Role of various causes of arterial desaturation in liver cirrhosis. Clin Sci 1969; 37: 803-814.

  36. Berthelot P, Walker JG, Scherlock S et al. Arterial changes in the lungs in cirrhosis of the liver lung spider nevi. NEJM 1966; 274: 291.

  37. Giampalmo A. The arteriovenous angiomatosis of lungs with hypoxemia. Acta Med Scand 1950; 248: 1-67.

  38. Hind CRK, Wong CM. Detection of arteriovenous fistulae in patients with cirrhosis by contrast two dimensional echocardiography. GUT 1981; 22: 1042-1045.

  39. Nakamura T, Nakamura S, Tazawa S et al. Measurement of blood through portopulmonary anastomosis in portal hypertension. J Lan Clin Med 1965; 65: 114-121.

  40. Calabresi P, Abelmann WH. Porto-caval and porto-pulmonary anastomoses in Laennec’s cirrhosis and in heart failure. J Clin Invest 1957; 36: 1257.

  41. Fritts HW Jr, Hardewig A, Rochester DF et al. Estimation of pulmonary arteriovenous shunt flow using intravenous injection of T-1824 dye and Kr 85. C Clin Invest 1960; 39: 1841.

  42. Khaliq SU, Kay JM, Heath D. Porta-pulmonary venous anastomoses in experimental cirrhosis of the liver in rats. J Pathol 1972; 107: 167-174.

  43. Krowka MJ, Cortese DA. Severe hypoxemia associated with liver disease: Mayo Clinic experience and the experimental use of almitrine bismesylate. Mayo Clinic Proc 1987; 62: 164-173.

  44. Felt RW, Kozak BE, Rosch J et al. Hepatogenic pulmonary angiodysplasia treated with coil spring embolization. Chest 1987; 91: 920-922.

  45. Agusti AG, Roca J, Rodriguez -Roisin R. Mechanisms of gas exchange impairment in patients with liver cirrhosis. Clin Chest Med 1996; 17: 49-66.

  46. Astrup J, Rorth M. Oxygen affinity of hemoglobin and red cell 2,3 diphosphoglycerate in hepatic cirrhosis. Scand J Clin Lab Invest 1973; 31: 311-317.

  47. Heinemann HO. Hyperventilation and arterial hypoxemia in cirrhosis of the liver. Am J Med 1960; 28: 239.

  48. Zimmon DS. Oxyhemoglobin dissociation in patients with hepatic encephalopaty. Gastroenterology 1967; 52: 647-654.

  49. Rodriguez- Roisisn R, Barvera JA. Hepatopulmonary syndrome: Is no the right answer? Gastroenterology 1997; 113: 682-684.

  50. O’Brien JD, Ettinger NA. Pulmonary complications of liver trasplantation. Clin Chest Med 1996; 17: 151-169.

  51. Mayoral V, Higenbottam TW, Cremona G et al. Exhaled nitric oxide is elevated in patients with hepatopulmonary syndrome. Am J Resp Crit Care Med 1994; 149: A26.

  52. Salem O, Dindzans V, Freeman J et al.Liver trasplantation following preoperative closure of intrapulmonary shunts. (Abstract). J Okla State Med Assoc 1994; 87: 53-55.

  53. Stizmann JV, Bulkely GB, Mitchell MC et al. Role of prostacyclin in the splanchnic hyperemia contributing to portal hypertension. Ann Surg 1989; 209: 322.

  54. Eriksson LS, Soderman C, Erickzon BG et al. Normalization of ventilatory/perfusion relationship after liver trasplantation in patients with descompensated cirrhosis. Evidence for a hepatopulmonary syndrome. Hepatology 1990; 12: 1350-1357.

  55. Chang SW, Ohara N. Pulmonary circulatory dysfunction in rats with biliary cirrhosis: An animal model of the hepatopulmonary syndrome. Am Rev Respir Dis 1992; 145: 798-805.

  56. Caldwell SH, Jeffers LJ, Narula S et al. Ancient remedies revisited: Does allium sativum (garlic) palliate the hepatopulmonary syndrome? J Clin Gastroenterology 1992; 15: 248-250.

  57. Shijo H, Sasaki H, Sakata et al. Reversibility of hepatopulmonary syndrome evidenced by serial pulmonary perfusion scan. Gastroenterol Jap 1993; 28: 126-131.

  58. Rolla G, Bucca C, Brussino L. Methylene blue in the hepatopulmonary syndrome. NEJM 1994; 331: 1098.

  59. Wettstein M, Halle M, Haussinger D. Pulmonary disorders in portal hypertension. Pulmonary hypertension and hepatopulmonary syndrome. Deutsche Medizinische Wochenschrift 1996; 121: 487-491.

  60. Saunders KB , Fernando SS, Dalton HR et al. Spontaneous improvement in a patient with the hepatopulmonary syndrome assessed by serial exercise tests. Thorax 1994; 49: 725-727.

  61. Riegler JL , Lang KA, Johnson SP et al. Transjugular intrahepatic portosystemic shunt improves oxygenation in hepatopulmonary syndrome. Gastroenterology 1995; 109: 978-983.

  62. Shah AN, Dodson F, Fung J. Role of nuclear medicine in liver trasplantation. Semin Nucle Med 1995; 25: 36-48.

  63. Alexander J, Greenough A, Baker A et al. Nitric oxide treatment of severe hypoxemia after liver trasplantation in hepatopulmonary syndrome. Case report. Liver Traspl Surg 1997; 3: 54-55.

  64. Cremona G, Higenbottam TW et al. Elevated exhaled nitric oxide in patients with hepatopulmonary syndrome. Eur Respir J 1995; 8: 1883-1885.

  65. Raffy O, Sleiman C, Vachiery F et al. Refractory hypoxemia during liver cirrhosis: Hepatopulmonary syndrome or primary pulmonary hypertension? Am J Respir Crit Care Med 1996; 153: 1169-1171.

  66. Song JY, Choi JY, Ko JT et al. Long term aspirin therapy for hepatopulmonary syndrome. Pediatrics 1996; 97: 917-920.

  67. King PD, Rumabaut R, Sanchez C. Pulmonary manifestations of chronic liver disease. Dig Dis 1996; 14: 73-82.

  68. Lange PA, Stoller JK. The hepatopulmonary syndrome: Effect of liver trasplantation. Clin Chest Med 1996; 17: 115-123.

  69. Panos RJ, Baker SK. Mediators, cytokines and growth factors in liver lungs interactions. Clin Chest Med 1996; 17: 151-169.

  70. Riestra A. Nitric oxide and hepatopulmonary syndrome. Med Clin 1996; 106: 597-598.

  71. Fallon MB , Abrams GA, McGrath JW et al. Common bile duct ligation in the rat. A model of intrapulmonary vasodilatation and hepatopulmonary syndrome. Am J Physiol 1997; 272: 779-784.

  72. Allgaier HP, Haag K, Blum HE. Hepatopulmonary syndrome. Zeischrift fur Gastroenterolie 1998; 36: 247-251.

  73. Chabot F, Mestiri H, Sabry S et al. Role of NO in the pulmonary artery hyporeactivity to phenylephrine in experimental biliary cirrhosis. Eur Respir J 1996; 9: 560-564.

  74. Lange PA, Stoller JK. The hepatopulmonary syndrome. Ann Intern Med 1995; 122: 521-529.

  75. Selim KM, Akriviadis EA, Zuckerman E et al. Transjugular intrahepatic portosystemic shunt. A succesful treatment for hepatopulmonary syndrome. Am J Gastroenterol 1998; 93: 455-458.

  76. Corley DA, Scharschmidt B, Bass N et al. Lack of efficacy of TIPS for hepatopulmonary syndrome. Gastroenterology 1997; 113: 1815-2025.

  77. Krowka MJ, Wiseman GA, Burnett AL, Spivey JR et al. Hepatopulmonary syndrome. A prospective study of relationship between severity of liver disease, PaO2 response to 100% Oxygen and brain uptake after Tc MAA lung scanning. Chest 1994; 118 (3): 521-533.

  78. Scott V, Miro A, Kang Y, De Wolff A, Bellary M, Martin M, Kramer D et al. Reversibility of the hepatopulmonary syndrome by orthotopic liver trasplantation. Trasplant Proc 1993; 25: 1787-1788.

  79. Cheng E, Woehlck H. Pulmonary artery hypertension complicating anesthesia for liver trasplantation. Anesthesiology 1992; 77: 375–378.

  80. Rich S, Dantzcker D, Ayres S, Bergofsky E, Brundage B, Detre K, Fishman A, Glodring R et al. Primary pulmonary hypertension. A national prospective study. Ann Intern Med 1987; 107: 121-23.

  81. Jones FD, Kuo PC, Johnson LB, Njoku MJ, Dixon-Ferguson MK et al. The coexistence of portopulmonary hypertension and hepatopulmonary syndrome. Anesthesiology 1999; 90 (2): 626-630.

  82. McDonnel P, Toye P, Hutchins G. Primary pulmonary hypertension and cirrhosis: Are they related? Am Rev Res Dis 1983; 127: 437-441.

  83. Krowka MJ, Porayko MK, Plevak DJ et al. Hepatopulmonary syndrome with progressive hypoxemia as an indication for liver trasplantation: Case reports and literature review. Mayo Clinic Proc 1997; 72: 44-53.

  84. Lange PA, Stoller JK. The hepatopulmonary syndrome. Effect of liver trasplantation. Clin Chest Med 1996; 17: 115-124.

  85. Irving L, Angus PW, Pretto JJ et al. Hepatopulmonary syndrome– response to liver trasplantation— new insights into and old problem. Aust NZJ Med 1993; 23: 639-640.

  86. Kitai T, Shinohara H, Hatano E et al. Postoperative monitoring of the oxygenation state of the graft liver in cases with hepatopulmonary syndrome. Trasplantation 1996; 62: 1676-1678.

  87. Thorens JB, Junod AF. Hypoxemia and liver cirrhosis. Eur Respir J 1992; 5: 75-79.

  88. Hoeper MM. Portopulmonary hypertension and hepatopulmonary syndrome. Lancet 2004; 362: 1461-1468.

  89. Martínez PG, Balust VJ, Taurá. Portopulmonary hypertension and hepatopulmonary syndrome. Crit Care Med 2005; 33 (1): 234.

  90. Wiklund RA. Preoperative preparation of patients with advanced liver disease. Crit Care Med 2004; 32 (suppl): S106-S115.

  91. Mandell MS. Hepatopulmonary syndrome and portopulmonary hypertension in the MELD era. Liver Traspl 2004; 10: S54-S58.




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