Living donor liver transplantation in a patient with severe portopulmonary hypertension

Sir, Porto-pulmonary hypertension (PoPH) is an uncommon (reported prevalence 5.3%),[1] but a dreaded complication of chronic liver disease (CLD) in patients undergoing liver transplant (LT). Since its development is not related to the severity of liver dysfunction[2] and the symptoms are non-specific, screening for POPH with transthoracic echocardiography (TTE) is recommended. Under standard monitoring including pulse oxymetry, electrocardiography, non invasive blood pressure and capnograpghic monitoring, anaesthesia was induced with fentanyl 250 μg and etomidate 10 mg. [...]RVSP must be recorded in all patients evaluated for LT with TTE.