Document Detail


Pulmonary complications after elective liver transplantation-incidence, risk factors, and outcome.
MedLine Citation:
PMID:  22885879     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
METHODS: The postoperative clinical course of 212 liver transplant recipients between January 2008 and April 2010 was analyzed. These patients were treated in a single intensive care unit and received standardized postoperative care.
RESULTS: During the postoperative period, 47 (22%) patients developed pneumonia, of whom 20 (43%) developed respiratory failure requiring mechanical ventilation. Univariate analysis showed that several preoperative factors (age of recipient, model for end-stage liver disease score, indication for LT, platelet count, and restrictive lung pattern revealed by preoperative pulmonary function tests) and the transfusion (blood units and fresh frozen plasma units) during the operative period were associated with pneumonia. Using multivariate analysis by logistic regression, only a restrictive lung pattern (odds ratio=3.14; 95% confidence interval, 1.51-6.51; P=0.002) and the international normalized ratio measured prior LT (OR=4.95; 95% confidence interval, 1.86-8.59; P=0.0004) were independent predictors of pneumonia after LT.
CONCLUSION: Pneumonia is common among patients undergoing LT and is a major cause of morbidity. A restrictive pattern on preoperative pulmonary testing and a higher international normalized ratio measured prior LT were associated with more risk of postoperative pneumonia.
Authors:
Eric Levesque; Emir Hoti; Daniel Azoulay; Isabelle Honore; Bruno Guignard; Eric Vibert; Philippe Ichai; Fadi Antoun; Faouzi Saliba; Didier Samuel
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Transplantation     Volume:  94     ISSN:  1534-6080     ISO Abbreviation:  Transplantation     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-09-07     Completed Date:  2012-11-19     Revised Date:  2013-05-10    
Medline Journal Info:
Nlm Unique ID:  0132144     Medline TA:  Transplantation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  532-8     Citation Subset:  IM    
Affiliation:
AP-HP Hôpital Paul Brousse, Centre Hépato-Biliaire, Villejuif, France. eric.levesque@pbr.aphp.fr
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Female
France / epidemiology
Hospital Mortality
Humans
Incidence
Length of Stay
Liver Transplantation / adverse effects*,  mortality
Logistic Models
Male
Middle Aged
Multivariate Analysis
Odds Ratio
Pneumonia, Bacterial / diagnosis,  epidemiology*,  microbiology,  mortality,  therapy
Predictive Value of Tests
Respiration, Artificial
Respiratory Insufficiency / etiology,  therapy
Risk Assessment
Risk Factors
Spirometry
Surgical Procedures, Elective
Time Factors
Treatment Outcome
Young Adult
Comments/Corrections
Comment In:
Transplantation. 2013 Apr 15;95(7):e43   [PMID:  23545510 ]
Transplantation. 2013 Apr 15;95(7):e43-4   [PMID:  23545511 ]

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