Outcomes of Liver Transplantation in Treated Portopulmonary Hypertension Patients With a Mean Pulmonary Arterial Pressure ≥35 mm Hg

Transplantation Direct
Hilary M DuBrockMichael J Krowka

Abstract

Portopulmonary hypertension (POPH), pulmonary arterial hypertension (PAH) that develops in the setting of portal hypertension, affects 5%-6% of patients with liver disease and is associated with significant morbidity and mortality. A mean pulmonary arterial pressure (mPAP) threshold of 35 mm Hg is used to stratify perioperative risk and liver transplant eligibility in treated POPH patients but does not take into account the specific factors that contribute to the pressure elevation. In this case series, we describe the characteristics and posttransplant outcomes of patients with treated POPH and an mPAP ≥35 mm Hg and pulmonary vascular resistance (PVR) <250 dynes-s-cm-5 at or just before liver transplantation (LT). We also describe the effect of PAH therapy on pulmonary hemodynamics in patients with POPH. Sixteen patients were included. All patients were on PAH therapy at the time of LT. PAH therapy resulted in a decrease of mPAP (median 18.4%; interquartile range [IQR] 8.9%-27.0%) with a reduction in PVR (median 50.5%; IQR, 45.4%-70.7%), and an increase in both cardiac output (CO) (median 28.1%; IQR 5.7%-63.8%) and PAWP (median 50.0%; IQR 16.7%-108.3%) before LT. One year posttransplant survival was 69% (11/16); however, only ...Continue Reading

References

Jul 29, 2000·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·M J KrowkaR A Krom
Feb 6, 2004·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Michael J KrowkaJoanne T Benson
Nov 24, 2006·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Michael J KrowkaRobert G Gish
Sep 11, 2008·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·K L SwansonM J Krowka
Jul 23, 2011·Chest·Michael J KrowkaMichael D McGoon
Sep 7, 2016·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Suman VermaJames W Ferguson
Dec 21, 2016·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Laurent SavaleOlivier Sitbon
Feb 14, 2017·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Sasiharan SithamparanathanUNKNOWN National Pulmonary Hypertension Service Research Collaboration of the United Kingdom and Ireland
Feb 17, 2017·Transplantation·Hilary M DuBrockRichard N Channick
Feb 6, 2020·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Rebecca DerooSarah Raevens
Mar 8, 2020·Journal of Hepatology·Laurent SavaleOlivier Sitbon
Jun 10, 2020·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Hilary M DuBrock, Michael J Krowka

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Citations

May 9, 2021·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Arun JoseJean M Elwing
Jun 15, 2021·Transplantation Direct·Sandeep SahayAdriano R Tonelli

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