Treatment of Chronic Liver Failure with Hepatopulmonary Syndrome in Chronic Liver Disease with Portal Hypertension

This protocol addresses chronic liver failure occurring in the setting of chronic liver disease complicated by portal hypertension and hepatopulmonary syndrome, specifically in patients with arterial PaO&sub2; below 60 mmHg — representing severe hypoxaemia.

Hepatopulmonary syndrome in the context of portal hypertension and chronic liver disease leads to significant arterial oxygen impairment. Patients with HPS and PaO&sub2; below 60 mmHg require evaluation for liver transplantation, as it represents the only intervention shown to be effective for HPS to date.

The structured regimen for this scenario includes an oxygen-based therapeutic strategy for patients with severe hypoxaemia — a recognised supportive measure in this population. The full protocol specifies the indication criteria, sequencing, and additional management steps.