Comparison of Post–Liver Transplantation Outcomes in Portopulmonary Hypertension and Pulmonary Venous Hypertension: A Single-Center Experience

Rajaram, Priyanka; Parekh, Anjali; Fisher, Micah R.; Kempker, Jordan A.; Subramanian, Ram

doi:10.1016/j.transproceed.2016.12.006

Cited by 12 publications

(14 citation statements)

References 13 publications

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“…The results of the SRTR study (2014 Salgia, et al) showed a higher 1-year mortality rate in PPH patients compared to patients without PPH ( P = 0.005) [ 6 ]. In the remaining 9 studies [ 5 , 13 , 15 – 19 ], there was no significant difference in 1-year mortality rates between the two groups. The combined 1-year mortality rate was 26.0% for the PPH group and 12.7% for the control group.…”

Section: Resultsmentioning

confidence: 99%

“…Recently growing evidence suggests that PPH should no longer be considered an absolute contraindication to LT unless PPH is severe and associated with right ventricular dysfunction [ 6 , 12 , 18 , 19 ]. Newer retrospective comparisons between patients with PPH and those without who underwent LT showed similar mortality between the two groups or slightly higher rates of death in PPH group that did not reach statistical significance [ 13 , 14 ]. In 2012, a prospective controlled study showed that there were no significant differences between the PPH group and the control group in terms of six-month patient and graft survivals (100% vs. 88.9, 100% vs. 100%, respectively) [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

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The early outcomes of candidates with portopulmonary hypertension after liver transplantation

et al. 2018

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BackgroundPortopulmonary hypertension (PPH) was once regarded as a contraindicaton to liver transplantation (LT). However, growing evidence has indicated that PPH patients undergoing LT may show similar outcomes compared to those without PPH, and researchers have recommended it not be an absolute contraindication. Given this controversy, we aimed to identify and review the current evidence on this topic and to provide a comparison of the outcomes after LT between candidates with PPH and those without.MethodsWe systematically searched the MEDLINE, EMBASE and Cochrane Library databases for all studies that compared the outcomes of PPH patients and those without PPH after LT. All studies reporting outcomes of PPH patients versus those without PPH (Control) were further considered for inclusion in this meta-analysis. Odds ratios (OR) and 95% confidence intervals (CI) were calculated to compare the pooled data between PPH and Control groups.ResultsEleven retrospective trials and one prospective, randomized, controlled trial, involving 37,686 transplant recipients were included. The PPH patients had increased 1-year mortality with an OR of 1.59 (95% CI = 1.26–2.01, P = 0.0001) compared to the control group. There was no significant difference in graft loss and 30-day mortality after LT between the two groups.ConclusionsPatients with PPH who underwent LT had increased 1-year mortality compared to those without PPH, while graft loss and 30-day mortality were similar. Nevertheless, LT may be a reasonable therapeutic option for some patients with PPH, but further studies are needed to identify those select patients with PPH who would benefit most from LT.Electronic supplementary materialThe online version of this article (10.1186/s12876-018-0797-8) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The early outcomes of candidates with portopulmonary hypertension after liver transplantation

et al. 2018

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“…DuBrock et al have reported an unadjusted 1-year posttransplant mortality rate of 14% similar to Salgia et al [46]. Rajaram et al performed a 10-year retrospective review between 2005 and 2015 with the objective to compare posttransplant outcomes of patients diagnosed with POPH and pulmonary venous hypertension versus patients without pulmonary hypertension [47]. The authors identified 28 patients with POPH, 13 of which underwent LT with an average MELD score of 21 [47].…”

Section: Porto-pulmonary Hypertensionmentioning

confidence: 92%

“…Rajaram et al performed a 10-year retrospective review between 2005 and 2015 with the objective to compare posttransplant outcomes of patients diagnosed with POPH and pulmonary venous hypertension versus patients without pulmonary hypertension [47]. The authors identified 28 patients with POPH, 13 of which underwent LT with an average MELD score of 21 [47]. One patient passed away intraoperatively; 30-day survival was 92.3%, and 1-year survival was 69.2% compared to a 1-year survival of 100% in the non-pulmonary hypertension group [47].…”

Section: Porto-pulmonary Hypertensionmentioning

confidence: 99%

Liver Transplantation

Bleszynski

Kim

2019

The Critically Ill Cirrhotic Patient

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“…No significant difference in mortality was noted between the no PH, PoPH, and PVH groups intraoperatively and 30 days after liver transplantation. At 1 year, the survival rates were 100%, 69.2%, and 94.1% in the no PH, PoPH and PVH groups, respectively …”

Section: Pulmonary Hypertensionmentioning

confidence: 97%

Liver transplantation and cardiac illness: Current evidences and future directions

Jha

Lata

2020

J Hepato Biliary Pancreat

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Contraindications to liver transplantation are gradually narrowing. Cardiac illness and chronic liver disease may manifest independently or may be superimposed on each other due to shared pathophysiology. Cardiac surgery involving the cardiopulmonary bypass in patients with Child-Pugh Class C liver disease is associated with a high risk of perioperative morbidity and mortality. Liver transplantation involves hemodynamic perturbations, volume shifts, coagulation abnormalities, electrolyte disturbances, and hypothermia, which may prove fatal in patients with cardiac illness depending upon the severity. Additionally, cardiovascular complications are the major cause of adverse postoperative outcomes after liver transplantation even in the absence of cardiac pathologies. Clinical decision-making has remained an unsettled issue in these clinical scenarios. The absence of randomized clinical studies has further crippled our endeavours for a consensus on the management of patients with end-stage liver disease with cardiac illness. This review seeks to address this complex clinical setting by gathering information from published literature. The management algorithm in this review may facilitate clinical decision making and augur future research.

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Comparison of Post–Liver Transplantation Outcomes in Portopulmonary Hypertension and Pulmonary Venous Hypertension: A Single-Center Experience

Cited by 12 publications

References 13 publications

The early outcomes of candidates with portopulmonary hypertension after liver transplantation

The early outcomes of candidates with portopulmonary hypertension after liver transplantation

Liver Transplantation

Liver transplantation and cardiac illness: Current evidences and future directions

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