Letrozole in Patients With Hepatopulmonary Syndrome

Inclusion Criteria

• •Diagnosis of moderate to very severe hepatopulmonary syndrome which consists of having all 3 of the following conditions:
• •* Presence of liver disease or portal hypertension
• •* Intrapulmonary shunting on contrast-enhanced echocardiogram
• •* Hypoxemia \[A-a gradient ≥15mmHg (or ≥20mmHg if age \>64) and PaO2\<80mmHg on arterial blood gas testing\]
• •Child-Pugh class A or B liver disease
• •MELD score \< 20
• •≥ 18 years old
• •Female subjects must be post-menopausal (defined as 12 months of spontaneous amenorrhea or 6 weeks postsurgical bilateral oophorectomy without or without hysterectomy)
• •Ability to provide informed consent