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Title: | Outcomes of liver transplantation for hepatopulmonary syndrome in patients with concomitant respiratory disease | Authors: | KOC, Ozgur Aslan, Devrim Kramer, Matthijs Verbeek, Jef Van Malenstein, Hannah van der Merwe, Schalk Monbaliu, Diethard VOS , Robin Verleden, Geert M. Pirenne, Jacques Nevens, Frederik |
Issue Date: | 2023 | Publisher: | WILEY | Source: | CLINICAL TRANSPLANTATION, | Status: | Early view | Abstract: | Background & aimsConcomitant respiratory disease is a common finding in patients with hepatopulmonary syndrome (HPS). Among patients who underwent liver transplantation (LT) for HPS, we compared characteristics and outcome of patients with versus without concomitant respiratory disease.MethodsThis single center retrospective observational study included patients with HPS who underwent LT between 1999 and 2020.ResultsDuring the study period, 32 patients with HPS received a LT; nine (28%) with concomitant respiratory disease of whom one required a combined lung-liver transplantation. Patients with concomitant respiratory disease had higher PaCO2 (38 vs. 33 mm Hg, p = .031). The 30-day postoperative mortality was comparable, but the estimated cumulative probability of resolution of oxygen therapy after LT in HPS patients with versus those without concomitant respiratory disease was lower: 63% versus 91% at 12 months and 63% versus 100% at 18 months (HR 95% CI .140-.995, p = .040). In addition to the presence of concomitant respiratory disease (p = .040), history of smoking (p = .012), and high baseline 99mTcMAA shunt fraction (>= 20%) (p = .050) were significantly associated with persistent need of oxygen therapy. The 5-year estimated cumulative probability of mortality in patients with concomitant respiratory disease was worse: 50% versus 23% (HR 95% CI .416-6.867, p = .463).ConclusionsThe presence of a concomitant respiratory disease did not increase the short-term postoperative mortality after LT in patients with HPS. However, it resulted in a longer need for oxygen therapy. | Notes: | Koc, ÖM (corresponding author), Maastricht Univ, Dept Internal Med, Div Gastroenterol & Hepatol, Med Ctr, P Debyelaan 25, NL-6229 HX Maastricht, Netherlands. o.koc@mumc.nl |
Keywords: | hepatopulmonary syndrome;liver transplantation;oxygen therapy;respiratory disease | Document URI: | http://hdl.handle.net/1942/41820 | ISSN: | 0902-0063 | e-ISSN: | 1399-0012 | DOI: | 10.1111/ctr.15171 | ISI #: | 001088301300001 | Rights: | 2023 The Authors. Clinical Transplantation published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. | Category: | A1 | Type: | Journal Contribution |
Appears in Collections: | Research publications |
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