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Eur Respir J. 2004 Oct;24(4):703-7.

Intravenous iloprost bridging to orthotopic liver transplantation in portopulmonary hypertension.

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  • 1Dept of Internal Medicine, University Hospital, Raemistrasse 100, CH-8091, Zurich, Switzerland.


Portopulmonary hypertension (PPHTN) is associated with poor prognosis and high perioperative mortality after orthotopic liver transplantation. This study documents the first case of a patient with PPHTN who was successfully bridged to orthotopic liver transplantation with i.v. iloprost, a stable prostacyclin analogue. The PPHTN had resolved completely 4 months after successful transplantation. In conclusion, portopulmonary hypertension is a relative contraindication to orthotopic liver transplantation, which should be attempted only if pulmonary haemodynamics improve with prostanoids. In this context, iloprost may be a valuable alternative to epoprostenol.

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