Hepatopulmonery syndrome

[David Patch]

am struggling with a patient.
HBV-normal LFTS prob macronodulkar cirrhosis. -ve HBV PCR on entecavir
HVPG 6
Albumin study negative
definite orthodeoxia
definite +ve echo with grade 3 shunt on 5th cycle
mild/mod pulmonery hypertension (not preclusive to liver transplantation)
Does require oxygen during the day-satn correct nicely

Do you need to have portal hypertension to have hepatopulmonery sysndrome?
WOuld you transplant this man all else being equal

[Jose Presa]

Hi David

Your patient has hepatopulmonary syndrome (HPS) not portopulmonary hypertension, because you describe a case of HPS and than mention mild/mod pulmonary hypertension? Important describe thoracic CT.
There are an association described between PSVD and HPS (https://doi.org/10.1016/j.jhepr.2024.101310) and your patients has lower HVPG. Check spleen elastography.
If is my patient all evaluate him/her to LT

[Author]

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