Early Portopulmonary Hypertension Predicts Mortality in Patients with Cirrhosis: Insights from the PORTO-DETECT Cohort

Strategic Insights -

Researchers have made significant progress in understanding the relationship between portopulmonary hypertension (PoPH) and mortality in patients with cirrhosis, according to a new study published in the Journal of Hepatology. The study, conducted by a team of researchers at Hospital Universitario Ramon y Cajal in Madrid, Spain, used data from the PORTO-DETECT cohort to evaluate the prognostic value of revised diagnostic criteria for pulmonary arterial hypertension (PAH). The findings suggest that early PoPH is a significant predictor of mortality in patients with cirrhosis and that applying the new criteria may help refine risk stratification and guide closer follow-up or earlier consideration of targeted interventions.

Key Takeaways:

  • The study included 428 adults with cirrhosis and portal hypertension who underwent right-heart catheterization between 2015 and 2023.
  • The patients were stratified into five groups: normal, early-PoPH, classic-PoPH, post-capillary pulmonary hypertension, and unclassified profiles.
  • Three-year survival rates were 76.7%, 49.5%, and 42.0% in the normal mPAP, early-PoPH, and classic-PoPH groups, respectively.
  • After adjustment for age, sex, liver function, and portal-hypertension severity, both early-PoPH (HR 3.5 [1.9 -6.3], p < 0.001) and classic-PoPH (HR 4.2 [2.4 - 7.2], p < 0.001) were associated with increased mortality.
  • The study highlights the prognostic relevance of early PoPH and suggests that applying the new criteria may help refine risk stratification and guide closer follow-up or earlier consideration of targeted interventions.

Statistics:

  • 428 adults with cirrhosis and portal hypertension were included in the study.
  • The patients were stratified into five groups: normal (n=115), early-PoPH (n=123), classic-PoPH (n=105), post-capillary pulmonary hypertension (n=30), and unclassified profiles (n=55).
  • The median follow-up time was 20.0 months (IQR 8.0 -36.0).
  • Three-year survival rates were:

+ 76.7% (95% CI 72.0-81.4) in the normal mPAP group.

+ 49.5% (95% CI 40.5-58.5) in the early-PoPH group.

+ 42.0% (95% CI 31.5-52.5) in the classic-PoPH group.

Sources:

  • NewsRx. New Findings from Hospital Universitario Ramon y Cajal in the Area of Portal Hypertension Described (Early portopulmonary hypertension predicts mortality in patients with cirrhosis: insights from the PORTO-DETECT cohort). Respiratory Therapeutics Week. October 27, 2025; p 3074.
  • Donate, J., Tellez, L., Guerrero, A., et al. (2025). Early portopulmonary hypertension predicts mortality in patients with cirrhosis: insights from the PORTO-DETECT cohort. Journal of Hepatology.