Analysis of Hepatopulmonary Syndrome In Liver Transplant: Portal Vein Thrombosis Might Be Relevant

Author Type(s)

Faculty, Resident/Fellow

Document Type

Abstract

Publication Date

2022

DOI

10.1111/ajt.16915

Journal Title

American Journal of Transplantation

Department

Surgery

Abstract

Introduction: Hepatopulmonary syndrome (HPS) is characterized by abnormalities in hypoxia associated with intrapulmonary vascular dilation in the context of liver disease. The mechanism of HPS remain limited. The aim of this study was to analyze the characteristics and outcomes of HPS in liver transplant. Methods: We analyzed data from the United Network for Organ Sharing (UNOS) database between 2002 - 2019. We included the patients diagnosed as HPS and excluded diagnosed malignancy. We compared the characteristics and outcomes of HPS with non-HPS. Results: 83,233 were included in this study. A total of 1,562 (1.9%) patients had LT for HPS. Recipient age, female, Caucasian, blood type O, HCV cirrhosis and NASH were significantly higher in HPS (p<0.05). Portal vein thrombosis (PVT) was significantly higher in HPS (11.4 vs 9.8%, p=0.042). Waitlist days were significantly longer (163 vs 73, p<0.01) and MELD score was significantly lower in HPS (14 vs 23, p<0.01). For outcomes, median length of hospitalization post-transplant was significantly longer in HPS (12 vs 10, p<0.01), one-year and five-year overall survivals did not have significant differences between each groups (90.8% vs 90.7%; 80.2% vs 80.0%, p=NS). On multivariable logistic regression analysis, PVT was one of the independent factors associated with HPS (Odds Ratio 1.22, p=0.016). Conclusions: HPS in liver transplant showed compatible outcomes compared to non-HPS. PVT might be associated with HPS.

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