Pulmonary Evaluation of Liver Transplant Candidates

Pulmonary conditions, such as chronic obstructive pulmonary disease, interstitial lung disease, hepatic hydrothorax, hepatopulmonary syndrome (HPS), and portopulmonary hypertension (POPH), commonly affect liver transplant (LT) candidates. A systematic preoperative pulmonary evaluation and a basic understanding of these conditions are necessary in order to recognize and manage these comorbid diseases. Pulmonary vascular complications of liver disease, such as HPS and POPH, can affect mortality as well as LT eligibility and prioritization. This chapter will provide an overview of the pulmonary evaluation of LT candidates with an emphasis on the perioperative evaluation and management of the pulmonary vascular complications of liver disease, i.e., HPS and POPH.