Highlights
- •Genetic predisposition and venovenous shunt favor the portopulmonary hypertension.
- •Hepatorenal reflex and sympathetic nervous system favor the hepatorenal syndrome.
- •Portopulmonary hypertension has a satisfactory prognosis after liver transplant.
- •Hepatorenal syndrome type1 has a worse prognosis than type 2.
Abstract
Portopulmonary hypertension and hepatorenal syndrome are both severe local hypertensive
complications of liver cirrhosis and portal hypertension. Both are characterized by
vasoconstrictive manifestations regarding pulmonary and renal vascular network, respectively.
This review addresses the mechanisms underlying the development of vasoconstriction
that leads to local vascular hypertension in the lung and in the kidney with the result
of organ dysfunction. Potential therapeutic options are available for the management
of these two syndromes as a bridge for liver transplantation; clinical efficacy depends
in part on the time and rapidity of intervention and in part on how serious the chain
of events is that has triggered the entire vasoconstrictive process.
Abbreviations:
HRS (hepatorenal syndrome), HVPG (hepatic venous pressure gradient), PPH (portopulmonary hypertension)Keywords
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Article info
Publication history
Published online: June 03, 2017
Accepted:
May 30,
2017
Received in revised form:
May 13,
2017
Received:
March 10,
2017
Footnotes
☆Grant Support: none.
☆Disclosures: the authors have nothing to disclose.
Identification
Copyright
© 2017 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
