Portopulmonary hypertension and the liver transplant candidate

Transplantation. 1999 Apr 27;67(8):1087-93. doi: 10.1097/00007890-199904270-00001.


The management of the liver transplant (OLT) candidate with portopulmonary hypertension (PPHTN) has dramatically changed in the past 3 years. Careful preoperative evaluation with functional characterization of right ventricular function plays a critical role. The pulmonary vascular response to epoprostenol infusion serves as a deciding factor for OLT candidacy. Careful perioperative attention to avoid right ventricular failure from acutely elevated pulmonary artery pressures or sudden increases in right ventricular preload is a key physiologic tenet of management. With increased surgical expertise, anesthetic sophistication, and availability of epoprostenol, PPHTN is no longer considered an absolute contraindication for OLT.

Publication types

  • Review

MeSH terms

  • Humans
  • Hypertension, Portal / complications*
  • Hypertension, Portal / diagnosis
  • Hypertension, Portal / drug therapy
  • Hypertension, Pulmonary / complications*
  • Hypertension, Pulmonary / diagnosis
  • Hypertension, Pulmonary / drug therapy
  • Liver Diseases / complications*
  • Liver Diseases / surgery*
  • Liver Transplantation*
  • Postoperative Period