Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020;11(4):166-175.

Hepatopulmonary Syndrome and Post-Liver Transplantation Complications: A Case-Control Study

A Morvan  1 , M Gazon  1 , S Duperret  1 , Z Schmitt  1 , P Pradat  2 , K Mohkam  3 , F Aubrun  1
Affiliations

Hepatopulmonary Syndrome and Post-Liver Transplantation Complications: A Case-Control Study

A Morvan et al. Int J Organ Transplant Med. 2020.

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.

Keywords: Hepatopulmonary syndrome; Liver cirrhosis; Liver transplantation; Post-operative complications.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Flow chart
Figure 2
Figure 2
Kaplan Meier survival curve at 1 year
See this image and copyright information in PMC

References

    1. Rodríguez-Roisin R, Krowka MJ. Hepatopulmonary syndrome--a liver-induced lung vascular disorder. N Engl J Med. 2008;358:2378–87. - PubMed
    1. Stoller JK, Lange PA, Westveer MK, et al. Prevalence and reversibility of the hepatopulmonary syndrome after liver transplantation. The Cleveland Clinic experience. West J Med. 1995;163:133–8. - PMC - PubMed
    1. Macêdo LG, Lopes EP de A, Albuquerque M de FPM de, et al. Occurrence of hepatopulmonary syndrome in patients with cirrhosis who are candidates for liver transplantation. J Bras Pneumol Publicaça̋o Of Soc Bras Pneumol E Tisilogia. 2010;36:432–40. - PubMed
    1. Schenk P, Schöniger-Hekele M, Fuhrmann V, et al. Prognostic significance of the hepatopulmonary syndrome in patients with cirrhosis. Gastroenterology. 2003;125:1042–52. - PubMed
    1. Martínez-Palli G, Gómez FP, Barberà JA, et al. Sustained low diffusing capacity in hepatopulmonary syndrome after liver transplantation. World J Gastroenterol. 2006;12:5878–83. - PMC - PubMed

LinkOut - more resources