Document Detail


The prevalence and the impact of portopulmonary hypertension on postoperative course in patients undergoing liver transplantation.
MedLine Citation:
PMID:  19765457     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Portopulmonary hypertension (PPH) is an uncommon but serious complication of chronic liver disease. It is accepted to be a poor prognostic factor in the follow-up of patients who have undergone orthotopic liver transplantation (OLT). The presence of severe PPH is accepted as a contraindication to OLT. In this study we sought to identify the prevalence and impact of PPH on the outcome of OLT patients. PATIENTS AND METHODS: We retrospectively analyzed the records of 114 adult OLT patients operated on at our institution. A complete transthoracic Doppler echocardiographic examination was performed preoperatively and postoperatively. To identify PPH, patients with Doppler echocardiographically measured systolic pulmonary artery pressure (SPAP) values of >or=30 mm Hg were defined as PPH. We noted the etiology of the liver disease, the postoperative mortality rates, and the pulmonary complications among OLT patients with PPH. RESULTS: In 24 patients we detected PPH, a prevalence of 21.1% among patients referred for OLT. Their mean age was 44.0 +/- 13.5 years; 18 patients (75.0%) were males. With regard to the Child classification, 16 (66.7%) were in class C. The mean SPAP was 46.6 +/- 7.6 mm Hg. Compared with preoperative values, a significant decrease in mean SPAP was noted postoperatively; 46.6 +/- 7.6 mm Hg vs 37.8 +/- 15.5 mm Hg (P < .05). Concerning postoperative pulmonary complications, pneumonia developed in 7 (29.2%), pleural effusion in 6 (25%), and respiratory failure and right ventricular failure in 1 (4.2%) subject. Compared with patients with a normal SPAP, the postoperative pulmonary complication rate was higher and the length of hospitalization longer among patients with PPH (P < .05). However, no difference was observed in terms of mortality rates (P > .05). CONCLUSION: This study indicated that SPAP decreased among patients with PPH following OLT. Although there was an increase in pulmonary complications, we observed no alteration in mortality rates. Therefore, we suggest that PPH may not be regarded as a contraindication for OLT.
Authors:
S S Bozbas; F O Eyuboglu; N G Arslan; F O Ergur; H Karakayali; M Haberal
Related Documents :
21196837 - Long-term analysis of upper incisor crowding. a longitudinal study orthodontically trea...
21199637 - Nicolau livedoid dermatitis following intramuscular benzathine penicillin injection.
21108587 - Esomeprazole for the treatment of peptic ulcer bleeding.
17122617 - A prospective, randomized, controlled trial comparing intermittent portal triad clampin...
20736787 - Indomethacin reduces cell damage: shedding new light on compartment syndrome.
18304417 - A clinical pilot study of fresh frozen plasma versus human albumin in paediatric cranio...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Transplantation proceedings     Volume:  41     ISSN:  1873-2623     ISO Abbreviation:  Transplant. Proc.     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-09-21     Completed Date:  2010-01-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0243532     Medline TA:  Transplant Proc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2860-3     Citation Subset:  IM    
Affiliation:
Department of Pulmonary Medicine, Baskent University Hospital, Ankara, Turkey. serifesb@gmail.com
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Female
Humans
Hypertension, Portal / epidemiology*,  physiopathology,  ultrasonography
Hypertension, Pulmonary / epidemiology*,  physiopathology,  ultrasonography
Liver Diseases / classification,  surgery
Liver Transplantation / adverse effects*,  mortality
Male
Postoperative Period
Prevalence
Prognosis
Retrospective Studies
Survival Rate
Survivors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Effect of graft type on postoperative liver function recovery in living liver donors.
Next Document:  Pediatric liver transplantation in iran: a 9-year experience.