Use of aerosolized inhaled epoprostenol in the treatment of portopulmonary hypertension

Abstract

Background: Portopulmonary hypertension is a known complication in the liver transplant candidate. Intravenous epoprostenol has been demonstrated to decrease pulmonary artery pressures and possibly remodel right ventricle geometry.

Methods: In this report, we document the efficacy of inhaled aerosolized epoprostenol in a patient with portopulmonary hypertension. The effect was of rapid onset and offset.

Results: After 10 min of delivery, mean pulmonary artery pressure decreased 26%; cardiac output increased by 22%; pulmonary vascular resistance decreased by 42%; and the transpulmonary gradient decreased by 29%. There were no untoward side effects.

Conclusion: The inhaled route of delivery of epoprostenol is potential alternative for the acute therapy of portpulmonary hypertension.