It is well known that arterial hypoxia can occur with chronic liver disease in adults as well as children.1-3 The clinical syndrome of hypoxia in association with liver disease has been called hepatopulmonary syndrome (HPS) or intrapulmonary vasodilative disease.3,4 In its classic form, HPS is a triad of abnormal arterial oxygenation, hepatic dysfunction, and pulmonary vascular dilation. The primary underlying disease of the hepatobiliary system is mainly liver cirrhosis or other chronic liver disease.4,5 The hypoxia is caused by either right-to-left shunting through arteriovenous connections within the lungs or a ventilation-perfusion imbalance caused by diffuse vasodilation of pulmonary arteries at the precapillary and capillary levels.1-3