When severe hepatopulmonary syndrome (PaO₂ <50 mmHg) coexists with borderline portopulmonary hemodynamics on therapy (e.g., mPAP high-30s with PVR ~3 WU), how do you sequence optimization and listing strategy, and what physiologic thresholds make you proceed to transplant versus defer for further pulmonary vascular optimization?
1 Answers
Mednet Member
Hepatology · Northwestern Memorial Hospital
This clinical scenario is more common than previously thought. Other than oxygen supplementation for hepatopulmonary syndrome (HPS), there is no other specific therapy. Portopulmonary hypertension (PoPH) needs to be treated to reach the threshold of desired mean pulmonary arterial pressure (mPAP) of...