Cartin-Ceba Rodrigo, Krowka Michael J
Division of Pulmonary and Critical Care Medicine, Mayo Clinic, 200 1st Street Southwest, Rochester, MN 55905, USA.
Division of Pulmonary and Critical Care Medicine, Mayo Clinic, 200 1st Street Southwest, Rochester, MN 55905, USA.
Clin Liver Dis. 2014 May;18(2):421-38. doi: 10.1016/j.cld.2014.01.004. Epub 2014 Feb 25.
Portopulmonary hypertension (POPH) is the presence of pulmonary arterial hypertension in patients with portal hypertension. Among liver transplant (LT) candidates, reported incidence rates of POPH range from 4.5% to 8.5%. In patients with LT, intraoperative death and immediate post-LT mortality are feared clinical events when transplantation is attempted in the setting of untreated, moderate to severe POPH; therefore, POPH precludes LT unless the mean pulmonary artery pressure can be reduced to a safe level and right ventricular function optimized. Specific pulmonary artery vasodilator medications seem effective in reducing pulmonary artery pressures and improving right ventricular function and survival.
门肺高压（POPH）是指门静脉高压患者中存在肺动脉高压。在肝移植（LT）候选者中，报道的POPH发病率在4.5%至8.5%之间。在LT患者中，当在未经治疗的中度至重度POPH情况下尝试进行移植时，术中死亡和LT术后即刻死亡率是令人担忧的临床事件；因此，除非平均肺动脉压能够降低到安全水平且右心室功能得到优化，否则POPH会使LT无法进行。特定的肺动脉血管扩张剂药物似乎在降低肺动脉压、改善右心室功能和提高生存率方面有效。
