Health Dictionary Find a Doctor

Hepatopulmonary syndrome risk factors

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Soroush Seifirad, M.D.[2]

Overview

Overview

There are no established risk factors for hepatopulmonary syndrome. Literally, It can happen in almost every patient with liver disease regardless of their disease stage, severity, chronicity, age, sex, or race. Nevertheless, polymorphism in nitric oxide and angiogenesis genes has been observed in patients who develop hepatopulmonary syndrome.

Risk Factors

Risk Factors

  • There are no established risk factors for hepatopulmonary syndrome.
  • Literally, It can happen in almost every patient with liver disease regardless of their disease stage, severity, chronicity, age, sex, or race.[1] [2]

[3][4] [5] [6] [7] [8]

  • Nevertheless, polymorphism in nitric oxide and angiogenesis genes has been observed in patients who develop hepatopulmonary syndrome.[9][10]

[11] [12] [13] [14]

References

References

  1. Rodríguez-Roisin R, Krowka MJ (2008) Hepatopulmonary syndrome–a liver-induced lung vascular disorder. N Engl J Med 358 (22):2378-87. DOI:10.1056/NEJMra0707185 PMID: 18509123
  2. Fallon MB, Abrams GA (2000) Pulmonary dysfunction in chronic liver disease. Hepatology 32 (4 Pt 1):859-65. DOI:10.1053/jhep.2000.7519 PMID: 11003635
  3. Krowka MJ, Mandell MS, Ramsay MA, Kawut SM, Fallon MB, Manzarbeitia C et al. (2004) Hepatopulmonary syndrome and portopulmonary hypertension: a report of the multicenter liver transplant database. Liver Transpl 10 (2):174-82. DOI:10.1002/lt.20016 PMID: 14762853
  4. Kennedy TC, Knudson RJ (1977) Exercise-aggravated hypoxemia and orthodeoxia in cirrhosis. Chest 72 (3):305-9. DOI:10.1378/chest.72.3.305 PMID: 891282
  5. Krowka MJ, Fallon MB, Kawut SM, Fuhrmann V, Heimbach JK, Ramsay MA et al. (2016) International Liver Transplant Society Practice Guidelines: Diagnosis and Management of Hepatopulmonary Syndrome and Portopulmonary Hypertension. Transplantation 100 (7):1440-52. DOI:10.1097/TP.0000000000001229 PMID: 27326810
  6. Krowka MJ, Dickson ER, Cortese DA (1993) Hepatopulmonary syndrome. Clinical observations and lack of therapeutic response to somatostatin analogue. Chest 104 (2):515-21. DOI:10.1378/chest.104.2.515 PMID: 8101797
  7. Swanson KL, Wiesner RH, Krowka MJ (2005) Natural history of hepatopulmonary syndrome: Impact of liver transplantation. Hepatology 41 (5):1122-9. DOI:10.1002/hep.20658 PMID: 15828054
  8. Rodríguez-Roisin R, Agustí AG, Roca J (1992) The hepatopulmonary syndrome: new name, old complexities. Thorax 47 (11):897-902. DOI:10.1136/thx.47.11.897 PMID: 1465744
  9. Cremona G, Higenbottam TW, Mayoral V, Alexander G, Demoncheaux E, Borland C et al. (1995) Elevated exhaled nitric oxide in patients with hepatopulmonary syndrome. Eur Respir J 8 (11):1883-5. PMID: 8620957
  10. Rolla G, Brussino L, Colagrande P, Dutto L, Polizzi S, Scappaticci E et al. (1997) Exhaled nitric oxide and oxygenation abnormalities in hepatic cirrhosis. Hepatology 26 (4):842-7. DOI:10.1053/jhep.1997.v26.pm0009328302 PMID: 9328302
  11. Nunes H, Lebrec D, Mazmanian M, Capron F, Heller J, Tazi KA et al. (2001) Role of nitric oxide in hepatopulmonary syndrome in cirrhotic rats. Am J Respir Crit Care Med 164 (5):879-85. DOI:10.1164/ajrccm.164.5.2009008 PMID: 11549549
  12. Luo B, Abrams GA, Fallon MB (1998) Endothelin-1 in the rat bile duct ligation model of hepatopulmonary syndrome: correlation with pulmonary dysfunction. J Hepatol 29 (4):571-8. PMID: 9824266
  13. Zhang J, Yang W, Hu B, Wu W, Fallon MB (2014) Endothelin-1 activation of the endothelin B receptor modulates pulmonary endothelial CX3CL1 and contributes to pulmonary angiogenesis in experimental hepatopulmonary syndrome. Am J Pathol 184 (6):1706-14. DOI:10.1016/j.ajpath.2014.02.027 PMID: 24731444
  14. Gómez FP, Barberà JA, Roca J, Burgos F, Gistau C, Rodríguez-Roisin R (2006) Effects of nebulized N(G)-nitro-L-arginine methyl ester in patients with hepatopulmonary syndrome. Hepatology 43 (5):1084-91. DOI:10.1002/hep.21141 PMID: 16628648

Looking for the patient version?

Back to the patient-friendly article

© 2026 MyEClinic – IFTM Institut für Telematik in der Medizin GmbH