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

Eur J Intern Med. 2017 Sep:43:22-27. doi: 10.1016/j.ejim.2017.05.028. Epub 2017 Jun 3.

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.

Keywords: Liver cirrhosis; Oesophageal varices; Portal hypertension.

Publication types

  • Review

MeSH terms

  • Disease Management
  • Hepatorenal Syndrome / physiopathology*
  • Hepatorenal Syndrome / therapy
  • Humans
  • Hypertension, Portal / physiopathology*
  • Hypertension, Portal / therapy
  • Hypertension, Pulmonary / physiopathology*
  • Hypertension, Pulmonary / therapy
  • Liver Cirrhosis / complications*
  • Liver Transplantation / adverse effects
  • Vasoconstrictor Agents / therapeutic use
  • Vasodilator Agents / therapeutic use

Substances

  • Vasoconstrictor Agents
  • Vasodilator Agents