Rapid assessment and safe management of severe pulmonary hypertension with milrinone during orthotopic liver transplantation.

The incidence of porto-pulmonary hypertension (PPHN) in patients with end stage liver disease is 8.5%. Evidence indicates that proceeding with orthotopic liver transplantation (OLT) in patients diagnosed with severe PPHN (mean pulmonary artery pressure [mPAP]>45 mmHg) at the time of OLT surgery is associated with high perioperative mortality.