| The prevalence and the impact of portopulmonary hypertension on postoperative course in patients undergoing liver transplantation. | |
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MedLine Citation:
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PMID: 19765457 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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S S Bozbas; F O Eyuboglu; N G Arslan; F O Ergur; H Karakayali; M Haberal |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Transplantation proceedings Volume: 41 ISSN: 1873-2623 ISO Abbreviation: Transplant. Proc. Publication Date: 2009 Sep |
Date Detail:
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Created Date: 2009-09-21 Completed Date: 2010-01-11 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0243532 Medline TA: Transplant Proc Country: United States |
Other Details:
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Languages: eng Pagination: 2860-3 Citation Subset: IM |
Affiliation:
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Department of Pulmonary Medicine, Baskent University Hospital, Ankara, Turkey. serifesb@gmail.com |
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| MeSH Terms | |
Descriptor/Qualifier:
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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 |
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