This review explains the liver-lung axis and major cirrhosis-related pulmonary complications: hepatopulmonary syndrome, portopulmonary hypertension, and hepatic hydrothorax. Although mechanisms differ, all can impair oxygenation, reduce function, and increase pre-transplant risk.
Key findings
- The three conditions have distinct pathogenesis and management despite shared effects on oxygenation and function. Distinguishing hepatopulmonary syndrome from portopulmonary hypertension matters because transplant implications differ. The HCV-pulmonary-fibrosis link remains debated.
Why this matters globally
Cirrhosis is managed across diverse health systems. A complication-specific framework can prevent breathlessness from being dismissed as ascites or deconditioning alone and support timely specialist referral.
Thai researcher contribution
Chulalongkorn University medical researchers synthesized physiologic and clinical knowledge of the liver-lung axis, linking diagnosis, symptom burden, and transplant planning.
Limitations to consider
As a narrative review, it may be affected by literature selection and provides no pooled estimates or certainty grading. Diagnostic and transplant criteria vary by guideline and center, and the article cannot replace patient-specific assessment.