Hepatopulmonary syndrome in waiting list and liver transplant
Background: Hepatopulmonary Syndrome (HPS) is an important pulmonary complication in cirrhotic patients with portal hypertension. Nevertheless, it is often not recognized in clinical practice, which results in inadequate treatment. The aim of this study was to evaluate the prevalence of HPS in patie...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2020-09-01
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| Series: | Transplantation Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2451959620300081 |
| _version_ | 1818283199034294272 |
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| author | Lucas Souto Nacif Erica Karen Dextre Torres Paola Sofia Espinoza Alvarez Juliana Marquezi Pereira Rafael Soares Pinheiro Vinicius Rocha-Santos Rodrigo Bronze Martino Daniel Reis Waisberg Rubens Arantes Macedo Liliana Ducatti Joel Avancini Rocha Filho Flávio Henrique Galvão Wellington Andraus Luiz Carneiro D´Albuquerque |
| author_facet | Lucas Souto Nacif Erica Karen Dextre Torres Paola Sofia Espinoza Alvarez Juliana Marquezi Pereira Rafael Soares Pinheiro Vinicius Rocha-Santos Rodrigo Bronze Martino Daniel Reis Waisberg Rubens Arantes Macedo Liliana Ducatti Joel Avancini Rocha Filho Flávio Henrique Galvão Wellington Andraus Luiz Carneiro D´Albuquerque |
| author_sort | Lucas Souto Nacif |
| collection | DOAJ |
| description | Background: Hepatopulmonary Syndrome (HPS) is an important pulmonary complication in cirrhotic patients with portal hypertension. Nevertheless, it is often not recognized in clinical practice, which results in inadequate treatment. The aim of this study was to evaluate the prevalence of HPS in patients who underwent liver transplantation (LT) and its impact in MELD (Model End-Stage Liver Disease) exception points policy. Methods: Retrospective study of all patients who underwent LT at our center from 2002 to 2019 combined with a cross-sectional and observational analysis of patients on waitlist on April 2019. Demographic and laboratory data as well as transthoracic contrast echocardiography findings and survival were analyzed from medical charts. Results: A total of 1395 LT were performed from 2002 to 2019. Exception MELD points due to HPS were assigned to 18 patients and 12 of them (0.85% of all LT) were transplanted. On April 2019, there were 150 patients on our waitlist, of which 12 (8%) met the criteria diagnosis for HPS, with 4 patients (33.3%) considered as mild, 4 (33.3%) as moderate, 2 (16.7%) as severe and 2 (16.7%) as were very severe. Four patients met the criteria for receiving MELD exception points due to HPS, nevertheless only 1 (25%) received the extra punctuation. Conclusion: HPS severely impacts prognosis on LT waitlist, making it paramount to achieve early diagnosis and obtain MELD exception points in order to perform LT as soon as possible. |
| first_indexed | 2024-12-13T00:33:06Z |
| format | Article |
| id | doaj.art-4e2cfbfd2eb9485aabfd5c53e71fd4e4 |
| institution | Directory Open Access Journal |
| issn | 2451-9596 |
| language | English |
| last_indexed | 2024-12-13T00:33:06Z |
| publishDate | 2020-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Transplantation Reports |
| spelling | doaj.art-4e2cfbfd2eb9485aabfd5c53e71fd4e42022-12-22T00:05:16ZengElsevierTransplantation Reports2451-95962020-09-0153100046Hepatopulmonary syndrome in waiting list and liver transplantLucas Souto Nacif0Erica Karen Dextre Torres1Paola Sofia Espinoza Alvarez2Juliana Marquezi Pereira3Rafael Soares Pinheiro4Vinicius Rocha-Santos5Rodrigo Bronze Martino6Daniel Reis Waisberg7Rubens Arantes Macedo8Liliana Ducatti9Joel Avancini Rocha Filho10Flávio Henrique Galvão11Wellington Andraus12Luiz Carneiro D´Albuquerque13Corresponding author.; Liver and Gastrointestinal Transplant Division. Department of Gastroenterology, University of São Paulo School of Medicine, BrazilLiver and Gastrointestinal Transplant Division. Department of Gastroenterology, University of São Paulo School of Medicine, BrazilLiver and Gastrointestinal Transplant Division. Department of Gastroenterology, University of São Paulo School of Medicine, BrazilLiver and Gastrointestinal Transplant Division. Department of Gastroenterology, University of São Paulo School of Medicine, BrazilLiver and Gastrointestinal Transplant Division. Department of Gastroenterology, University of São Paulo School of Medicine, BrazilLiver and Gastrointestinal Transplant Division. Department of Gastroenterology, University of São Paulo School of Medicine, BrazilLiver and Gastrointestinal Transplant Division. Department of Gastroenterology, University of São Paulo School of Medicine, BrazilLiver and Gastrointestinal Transplant Division. Department of Gastroenterology, University of São Paulo School of Medicine, BrazilLiver and Gastrointestinal Transplant Division. Department of Gastroenterology, University of São Paulo School of Medicine, BrazilLiver and Gastrointestinal Transplant Division. Department of Gastroenterology, University of São Paulo School of Medicine, BrazilLiver and Gastrointestinal Transplant Division. Department of Gastroenterology, University of São Paulo School of Medicine, BrazilLiver and Gastrointestinal Transplant Division. Department of Gastroenterology, University of São Paulo School of Medicine, BrazilLiver and Gastrointestinal Transplant Division. Department of Gastroenterology, University of São Paulo School of Medicine, BrazilLiver and Gastrointestinal Transplant Division. Department of Gastroenterology, University of São Paulo School of Medicine, BrazilBackground: Hepatopulmonary Syndrome (HPS) is an important pulmonary complication in cirrhotic patients with portal hypertension. Nevertheless, it is often not recognized in clinical practice, which results in inadequate treatment. The aim of this study was to evaluate the prevalence of HPS in patients who underwent liver transplantation (LT) and its impact in MELD (Model End-Stage Liver Disease) exception points policy. Methods: Retrospective study of all patients who underwent LT at our center from 2002 to 2019 combined with a cross-sectional and observational analysis of patients on waitlist on April 2019. Demographic and laboratory data as well as transthoracic contrast echocardiography findings and survival were analyzed from medical charts. Results: A total of 1395 LT were performed from 2002 to 2019. Exception MELD points due to HPS were assigned to 18 patients and 12 of them (0.85% of all LT) were transplanted. On April 2019, there were 150 patients on our waitlist, of which 12 (8%) met the criteria diagnosis for HPS, with 4 patients (33.3%) considered as mild, 4 (33.3%) as moderate, 2 (16.7%) as severe and 2 (16.7%) as were very severe. Four patients met the criteria for receiving MELD exception points due to HPS, nevertheless only 1 (25%) received the extra punctuation. Conclusion: HPS severely impacts prognosis on LT waitlist, making it paramount to achieve early diagnosis and obtain MELD exception points in order to perform LT as soon as possible.http://www.sciencedirect.com/science/article/pii/S2451959620300081Liver transplantationHepatopulmonary syndromeWaiting list |
| spellingShingle | Lucas Souto Nacif Erica Karen Dextre Torres Paola Sofia Espinoza Alvarez Juliana Marquezi Pereira Rafael Soares Pinheiro Vinicius Rocha-Santos Rodrigo Bronze Martino Daniel Reis Waisberg Rubens Arantes Macedo Liliana Ducatti Joel Avancini Rocha Filho Flávio Henrique Galvão Wellington Andraus Luiz Carneiro D´Albuquerque Hepatopulmonary syndrome in waiting list and liver transplant Transplantation Reports Liver transplantation Hepatopulmonary syndrome Waiting list |
| title | Hepatopulmonary syndrome in waiting list and liver transplant |
| title_full | Hepatopulmonary syndrome in waiting list and liver transplant |
| title_fullStr | Hepatopulmonary syndrome in waiting list and liver transplant |
| title_full_unstemmed | Hepatopulmonary syndrome in waiting list and liver transplant |
| title_short | Hepatopulmonary syndrome in waiting list and liver transplant |
| title_sort | hepatopulmonary syndrome in waiting list and liver transplant |
| topic | Liver transplantation Hepatopulmonary syndrome Waiting list |
| url | http://www.sciencedirect.com/science/article/pii/S2451959620300081 |
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