トクシゲ　カツトシ   TOKUSHIGE Katsutoshi   徳重　克年    所属   医学部 医学科（東京女子医科大学病院）    職種   客員教授
論文種別	原著
言語種別	英語
査読の有無	査読なし
表題	Current Therapy and Liver Transplantation for Portopulmonary Hypertension in Japan.
掲載誌名	正式名：Journal of clinical medicine 略　 称：J Clin Med ISSNコード：20770383/20770383
掲載区分	国外
巻・号・頁	12(2),pp.562
著者・共著者	TOKUSHIGE Katsutoshi†, KOGISO Tomomi, EGAWA Hiroto
担当区分	筆頭著者,責任著者
発行年月	2023/01
概要	Portopulmonary hypertension (PoPH) and hepatopulmonary syndrome are severe pulmonary complications associated with liver cirrhosis (LC) and portal hypertension. Three key pathways, involving endothelin, nitric oxide, and prostacyclin, have been identified in the development and progression of pulmonary arterial hypertension (PAH). To obtain a good effect with PAH-specific drugs in PoPH patients, it is important to diagnose PoPH at an early stage and promptly initiate therapy. The majority of therapeutic drugs are contraindicated for Child-Pugh grade C LC, and their effects decrease in the severe PAH stage. Among many LC patients, the measurement of serum brain natriuretic peptide levels might be useful for detecting PoPH. Previously, liver transplantation (LT) for PoPH was contraindicated; however, the indications for LT are changing and now take into account how well the PoPH is controlled by therapeutic drugs. In Japan, new registration criteria for deceased-donor LT have been established for PoPH patients. PoPH patients with a mean pulmonary arterial pressure <35 mmHg and pulmonary vascular resistance <400 dyn/s/cm−5 are indicated for LT, regardless of whether they are using therapeutic drugs. Combined with PAH-specific drugs, LT may lead to excellent long-term outcomes in PoPH patients. We aimed to review current therapies for PoPH, including LT.
DOI	10.3390/jcm12020562
PMID	36675490