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Panminerva Medica 2003 Giugno;45(2):95-8

lingua: Inglese

Hepatopulmonary syndrome. A review of the literature

Ghittoni G. 1, Valentini G. 1, Spada C. 1, Rossi Z. 2, Gasbarrini G. 1

1 Institute of Internal Medicine, Catholic University of Rome, Rome, Italy
2 Gastroenterology Unit, Department of Endocrine, Metabolic and Digestive Diseases, Regina Apostolorum Hospital, Albano, Rome, Italy


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The major­ity of cir­rhot­ic ­patients ­present dysp­nea, but ­most of the ­time ­this is a con­se­quence of ­ascites, hepat­ic hydro­thor­ax or car­di­o­pul­mo­nary dis­ease. Very few of ­these ­patients under­go the hepat­o­pul­mo­nary syn­drome, an infre­quent com­pli­ca­tion of chron­ic liv­er dis­ease, espe­cial­ly ­when asso­ciat­ed ­with por­tal hyper­ten­sion and cir­rho­sis. Hepatopulmonary syn­drome is char­ac­ter­ised by dysp­nea and, con­se­quent­ly, arte­ri­al hypox­e­mia, due to intra­pul­mo­nary vasod­i­la­tion and shunt­ing. The ­real path­o­gen­e­sis of ­this vasod­i­la­tion is ­still ­unknown, ­although ­many hypoth­e­ses ­have ­been sug­gest­ed. Furthermore, no med­i­cal ther­a­py ­appears to be real­ly use­ful in the treat­ment of hepat­o­pul­mo­nary syn­drome. At the ­present ­time, the ­only treat­ment ­that is effi­ca­cious for the res­o­lu­tion, or for the improve­ment of ­blood gas oxy­gen­a­tion abnor­mal­ities, is ortho­top­ic liv­er trans­plan­ta­tion.

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