Hepatopulmonary syndrome may affect you if you have chronic liver disease. The condition affects capillaries in your lungs, so they can’t absorb oxygen that your blood carries from your liver to your lungs. When that happens, you develop hypoxemia (low blood oxygen levels). Treatment is oxygen therapy to ease symptoms or a liver transplantation.
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Hepatopulmonary syndrome is a rare complication of chronic liver disease. It affects the capillaries in your lungs. “Hepato-” means “of the liver,” and “-pulmonary” means “of the lungs.” This condition causes low oxygen levels in your blood. This can make it hard for you to breathe.
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This disease happens when changes in your liver make capillaries in your lungs widen or dilate. Your capillaries contain red blood cells that carry oxygen throughout your body. When they dilate, your red blood cells can’t absorb oxygen. Trouble breathing can affect your quality of life. Severe hypoxemia may damage your brain and heart.
Hepatopulmonary syndrome may not cause symptoms early on. Shortness of breath is often the first symptom people notice. Other symptoms that develop later include:
Experts don’t understand the connection between liver disease and widening capillaries in your lungs. One theory is that liver disease keeps your liver from filtering toxins (harmful substances) in your blood. When that happens, toxins may build up in your capillaries, so they widen.
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Hepatopulmonary syndrome may cause hypoxemic hypoxia. This is low oxygen levels in your tissues and organs. Hypoxemic hypoxia can damage your brain and heart and may be life-threatening.
Most people with hepatopulmonary syndrome already have a liver disease diagnosis. But some people may develop hepatopulmonary syndrome symptoms without that diagnosis. In that case, a healthcare provider will order liver function tests. If tests show you have liver disease, a provider will order tests to measure the oxygen content in your blood. Those tests may include:
Healthcare providers look for specific medical conditions to diagnose hepatopulmonary syndrome. They may call these conditions the triad of hepatopulmonary syndrome. The diagnostic criteria for hepatopulmonary syndrome are:
Treatment typically involves oxygen therapy to boost your oxygen levels. You may have hyperbaric oxygen therapy or receive oxygen through a mask.
The only cure is a liver transplantation to give you a healthy liver. The transplantation will cure the underlying liver disease and eliminate hepatopulmonary syndrome symptoms. However, not everyone is a candidate for a liver transplantation. Those who qualify have to wait for a matching donor liver.
That depends on your treatment. A successful liver transplantation will give you a healthy liver. But it may take six months to a year for your capillaries to shrink and your blood oxygen levels to return to normal.
Research shows about 76% of people who had a successful liver transplantation are alive five years after their transplantation. That survival rate drops two years for people who don’t have a liver transplantation. But many factors affect survival rate. Your situation may be different from that of another person with the disease. If you have survival rate questions, your healthcare team is your best resource for information.
Hepatopulmonary syndrome is a complication of chronic liver disease. Treatment may ease some hepatopulmonary symptoms. Taking care of your liver may help. Here are some things you can do for your liver:
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Hepatopulmonary syndrome leaves you short of breath. You may have oxygen therapy to help ease your symptoms. Contact your provider if it’s becoming more difficult for you to breathe even though you’re receiving oxygen.
This is a medical term for when capillaries dilate so your red blood cells can’t absorb oxygen. A healthcare provider may call this intrapulmonary shunting.
Chronic liver disease may cause hepatopulmonary syndrome. If that’s your situation, you may feel frustrated and worried because you have yet another serious medical issue that you must manage. Healthcare providers have treatments for hepatopulmonary syndrome symptoms. But the only cure is a liver transplantation. You may feel helpless if you’re waiting on a donor liver. But there are things you can do to support your liver’s health. Ask a provider for recommendations.
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Last reviewed on 06/24/2025.
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