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Portopulmonary hypertension and hepatorenal syndrome. Two faces of the same coin

      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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