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Hepatopulmonary Syndrome and Post-Liver Transplantation Complications: A Case-Control Study.
A Morvan1, M Gazon1, S Duperret1
1Department of Anesthesiology and Critical Care Croix-Rousse University Hospital, Hospices Civils de Lyon (HCL), Lyon, France.
International Journal of Organ Transplantation Medicine
|December 18, 2020
Summary
Patients with hepatopulmonary syndrome (HPS) experience more post-liver transplant complications, particularly cardiac and infectious issues, within the first month. However, HPS patients show improved 1-year survival after liver transplantation (LT).
Area of Science:
- Hepatology
- Transplantation Medicine
- Pulmonary Medicine
Background:
- Liver transplantation (LT) enhances survival for cirrhotic patients with hepatopulmonary syndrome (HPS).
- Limited data exist on post-LT complications in HPS patients.
Purpose of the Study:
- To compare the incidence of post-LT complications between patients with and without HPS.
- To identify specific complication types and outcomes in HPS patients undergoing LT.
Main Methods:
- Retrospective case-control study of LT patients from January 2010 to July 2016.
- Matched comparison of 71 HPS patients against controls based on MELD score, age, comorbidities, transfusion, and vasopressor use.
Main Results:
- HPS patients had significantly more post-operative complications (median 5 vs. 3, p<0.001).
- Higher rates of cardiac (39.4% vs. 12.7%), infectious (81.7% vs. 49.3%), and surgical complications (59.2% vs. 40.1%) were observed in HPS patients.
- HPS patients had increased 1-month ICU readmissions (10 vs. 1, p=0.01) but higher 1-year survival (94.4% vs. 81.1%, p=0.034).
Conclusions:
- HPS patients face a greater number of complications in the initial month post-LT.
- Despite increased early complications, LT offers improved 1-year survival for HPS patients.
