Table of contents
Portopulmonary hypertension
Guidelines
Key sources
The following summarized guidelines for the evaluation and management of portopulmonary hypertension are prepared by our editorial team based on guidelines from the European Association for the Study of the Liver (EASL 2024,2018), the Society of Critical Care Medicine (SCCM 2020), the International Liver Transplantation Society (ILTS 2016), and the American Association for the Study of Liver Diseases (AASLD 2014).
1
2
3
4
5
Screening and diagnosis
Indications for testing
As per ILTS 2016 guidelines:
Obtain Doppler transthoracic echocardiography to screen for POPH in patients with portal hypertension being candidates for TIPS insertion or liver transplantation.
B
Obtain repeated screening for POPH in patients with portal hypertension while waiting for liver transplantation. B
Recognize that female gender and autoimmune liver diseases are risk factors for POPH, but do not use these for screening.
B
More topics in this section
Diagnostic criteria
Differential diagnosis
Classification and risk stratification
Diagnostic investigations
Echocardiography
As per EASL 2018 guidelines:
Obtain Doppler TTE to screen for POPH in patients deemed potential recipients for TIPS or liver transplantation.
B
Obtain repeated echocardiography in patients with POPH listed for transplantation.
B
More topics in this section
Vasoreactivity testing
Diagnostic procedures
Medical management
Pulmonary arterial hypertension-specific pharmacotherapy: as per SCCM 2020 guidelines, consider treating POPH with agents approved for pulmonary arterial hypertension in patients with mean pulmonary artery pressure > 35 mmHg.
C
More topics in this section
Medications to avoid
Perioperative care
Perioperative monitoring: as per ILTS 2016 guidelines, obtain pulmonary artery catheter monitoring before and during liver transplantation in all adult patients.
B
Show 2 more
More topics in this section
Perioperative medical therapy
Postoperative evaluation