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. 2025 Feb 27;17(2):99134.
doi: 10.4254/wjh.v17.i2.99134.

Survival of patients with hepatopulmonary syndrome related to cirrhotic and non-cirrhotic (schistosomiasis) portal hypertension

Melissa M Rolim  1 , Liana G Farsoun  2 , Carlos F Luna  3 , Brivaldo Markman-Filho  4   5 , Paulo Querette  6 , Edmundo P Lopes  7   5   8 , Ana L Domingues  7   5   8
Affiliations

Survival of patients with hepatopulmonary syndrome related to cirrhotic and non-cirrhotic (schistosomiasis) portal hypertension

Melissa M Rolim et al. World J Hepatol. .

Abstract

Background: The hepatosplenic schistosomiasis (HSS) with portal hypertension can cause vascular complications such as hepatopulmonary syndrome (HPS). HPS increases the risk of mortality in patients with cirrhosis; however, there is no data on the mortality of patients with HSS and HPS.

Aim: To perform a survival analysis of patients with HPS related to cirrhotic and non-cirrhotic (schistosomiasis) portal hypertension.

Methods: From August 2023 to January 2024, medical records and the official mortality information service of 121 patients who participated in a cross-sectional study on HPS between 2010 and 2012 were analyzed. Survival curves were created using the Kaplan-Meier method, and comparisons were performed using the log-rank test. Cox regression models estimated the hazard ratios (HR).

Results: Overall, data of 113 patients were analyzed; most (55.8%) had HSS and concomitant cirrhosis (HSS/cirrhosis). Meanwhile, HPS was present in 39 (34.5%) patients. Death occurred in 65 patients [57.5%; 95% confidence interval (CI): 48%-67%. The average time to death was lower in those with HPS when compared to those without HPS (3.37 years vs 5.65 years; P = 0.017). According to the cause of liver disease, patients with HSS/cirrhosis died earlier, and their risk of death was twice as high compared with patients with HSS without cirrhosis (HR: 2.17; 95%CI: 1.3-3.60; P = 0.003). Meanwhile, there were no differences when comparing the two groups with and without HPS (HR: 1.01; 95%CI: 0.59-1.73; P = 0.967).

Conclusion: Patients with HSS and concomitant cirrhosis had a lower survival rate, but there was no difference in survival regardless of the presence of HPS.

Keywords: Hepatopulmonary syndrome; Mortality; Non-cirrhotic portal hypertension; Portal hypertension; Schistosomiasis; Survival.

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Conflict of interest statement

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Figures

Figure 1
Figure 1
Distribution of the 121 patients with portal hypertension according to the occurrence of death and etiology of liver disease (cirrhotic or non-cirrhotic) reassessed after 10 years, Recife, 2024. HSS: Hepatosplenic schistosomiasis.
Figure 2
Figure 2
Kaplan-Meier survival curves of the 113 patients. A: Kaplan-Meier survival curves of the 113 patients according to the presence of hepatopulmonary syndrome; B: Kaplan-Meier survival curves of the 113 patients according to the etiology of the liver disease, hepatosplenic schistosomiasis or hepatosplenic schistosomiasis/cirrhosis. HR: Hazard ratios.
See this image and copyright information in PMC

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