In Reply We thank Bakinde et al for their interest in our work1 and allowing us to elaborate on the time course of the development of portopulmonary hypertension (PoPH). Typically, PoPH occurs 4 to 7 years after patients are diagnosed with portal hypertension.2 In some cases, however, the timeline is much faster. In one study,3 3 of 155 patients who did not have PoPH at initial evaluation by Doppler echocardiogram and right heart catheterization were found to have new-onset PoPH at the time of transplantation, just 2.5, 3.0, and 5.0 months later. In a few months, the mean pulmonary vascular resistance of these patients had increased from a baseline of 60.3 dynes · s · cm−5 to 184.3 dynes · s · cm−5 indicating that PoPH may occasionally develop within a very short time frame.3
Identify all potential conflicts of interest that might be relevant to your comment.
Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.
Err on the side of full disclosure.
If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.
Not all submitted comments are published. Please see our commenting policy for details.
Littmann L, Potter JK, Hoglund JR. Further Questions Regarding Electrocardiogram Prior to Liver Transplant—Reply. JAMA Intern Med. 2018;178(4):586–587. doi:10.1001/jamainternmed.2018.0572
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: