A Morvan1, M Gazon1, S Duperret1, Z Schmitt1, P Pradat2, K Mohkam3, F Aubrun1. 1. Department of Anesthesiology and Critical Care Croix-Rousse University Hospital, Hospices Civils de Lyon (HCL), Lyon, France. 2. Department of Hepatology, Clinical Research Center Croix-Rousse University Hospital, Hospices Civils de Lyon (HCL), Lyon, France. 3. Department of Digestive, Hepato-biliary and Liver Transplantation Surgery, Croix-Rousse University Hospital, Hospices Civils de Lyon (HCL), Lyon, France.
Abstract
BACKGROUND: Although liver transplantation (LT) improves survival in cirrhotic patients with hepatopulmonary syndrome (HPS), few data exist concerning post-operative complications in these patients. OBJECTIVE: To compare complications after LT between patients with and without HPS. METHODS: In a case-control study, we retrospectively analyzed all patients who underwent LT in our center from January 2010 to July 2016. We compared cases of identified HPS to controls matched for age, MELD score, comorbidities, red blood cells transfused, and highest dosage of norepinephrine perfused during transplantation. RESULTS: Among 451 transplanted patients, we identified 71 patients with HPS who could be analyzed. We found a significantly (p<0.001) higher number of post-operative complications in patients with HPS (median 5 vs 3), with more occurrence of cardiac, infectious and surgical complications than in the controls: 39.4% vs 12.7% (p<0.001), 81.7% vs 49.3% (p<0.001), and 59.2% vs 40.1% (p<0.029), respectively. There were also more ICU readmissions at 1 month among HPS patients (10 vs 1, p=0.01). There was no significant difference concerning ventilation data, lengths of ICU or hospital stay (8.5 [range 3-232] and 32 [14-276] days, respectively on the whole cohort) and death in the ICU (4.2% on the whole cohort). The 1-year survival was higher in HPS patients (94.4% vs 81.1%, p=0.034); there was no difference in 5-year survival. CONCLUSION: HPS patients seem to have a higher number of complications in the first month following LT.
BACKGROUND: Although liver transplantation (LT) improves survival in cirrhotic patients with hepatopulmonary syndrome (HPS), few data exist concerning post-operative complications in these patients. OBJECTIVE: To compare complications after LT between patients with and without HPS. METHODS: In a case-control study, we retrospectively analyzed all patients who underwent LT in our center from January 2010 to July 2016. We compared cases of identified HPS to controls matched for age, MELD score, comorbidities, red blood cells transfused, and highest dosage of norepinephrine perfused during transplantation. RESULTS: Among 451 transplanted patients, we identified 71 patients with HPS who could be analyzed. We found a significantly (p<0.001) higher number of post-operative complications in patients with HPS (median 5 vs 3), with more occurrence of cardiac, infectious and surgical complications than in the controls: 39.4% vs 12.7% (p<0.001), 81.7% vs 49.3% (p<0.001), and 59.2% vs 40.1% (p<0.029), respectively. There were also more ICU readmissions at 1 month among HPS patients (10 vs 1, p=0.01). There was no significant difference concerning ventilation data, lengths of ICU or hospital stay (8.5 [range 3-232] and 32 [14-276] days, respectively on the whole cohort) and death in the ICU (4.2% on the whole cohort). The 1-year survival was higher in HPS patients (94.4% vs 81.1%, p=0.034); there was no difference in 5-year survival. CONCLUSION: HPS patients seem to have a higher number of complications in the first month following LT.
Authors: Camille Taillé; Jacques Cadranel; Agnès Bellocq; Gabriel Thabut; Olivier Soubrane; François Durand; Philippe Ichaï; Christophe Duvoux; Jacques Belghiti; Yvon Calmus; Hervé Mal Journal: Transplantation Date: 2003-05-15 Impact factor: 4.939
Authors: Michael J Krowka; M Susan Mandell; Michael A E Ramsay; Steve M Kawut; Michael B Fallon; Cosme Manzarbeitia; Manuel Pardo; Paul Marotta; Shinji Uemoto; Markus P Stoffel; Joanne T Benson Journal: Liver Transpl Date: 2004-02 Impact factor: 5.799