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Liver Transplant Outcomes in Patients With Postcapillary Pulmonary Hypertension
Cerise Kleb1, Manik Aggarwal2, Adriano R Tonelli3
1Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, OH.
Transplantation Direct
|October 17, 2022
Summary
Postcapillary pulmonary hypertension (PH) in cirrhosis patients did not significantly impact liver transplant (LT) survival. Higher cardiac output may improve survival in these PH patients post-LT.
Area of Science:
- Hepatology
- Pulmonology
- Transplantation Medicine
Background:
- Cirrhosis commonly presents with postcapillary pulmonary hypertension (PH).
- Limited research exists on postcapillary PH outcomes following liver transplantation (LT).
- Portopulmonary hypertension has established research and treatment guidelines, unlike postcapillary PH.
Purpose of the Study:
- To investigate the impact of postcapillary PH on patient outcomes after LT.
- To compare survival and other post-LT complications in patients with and without postcapillary PH.
Main Methods:
- Retrospective cohort study of 1173 LT patients (2010-2020).
- Propensity score matching and multivariable Cox modeling were used for analysis.
- Compared post-LT survival and outcomes between patients with and without postcapillary PH.
Main Results:
- Of 1173 patients, 68 had PH, and 50 had postcapillary PH.
- No significant difference in post-LT mortality was observed between patients with postcapillary PH and those without (HR 1.72, P=0.10).
- Patients with postcapillary PH who survived had significantly higher cardiac output (11 L/min) compared to those who died (8 L/min, P=0.03).
Conclusions:
- Postcapillary PH does not appear to negatively affect survival after LT.
- Elevated cardiac output may be a protective factor against mortality in LT recipients with postcapillary PH.
