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Gastroenterologie
a hepatologie

Gastroenterology and Hepatology

Gastroent Hepatol 2020; 74(4): 295–301. doi:10.14735/amgh2020295.

Portopulmonary hypertension in liver transplant candidates – experience of transplantation centre IKEM

Petra Pavlíková1, Hikmet Al-Hiti2, Pavel Taimr Orcid.org  1

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Summary

Introduction:
Pulmonary hypertension associated with portal hypertension, i.e. portopulmonary hypertension (POPH), is a rare but serious complication arising in patients with liver cirrhosis. The detection of POPH is clinically important in those who are indicated for liver transplantation (OLTx). Unrecognized or untreated, even moderate pulmonary hypertension significantly increases the risk of heart failure in the perioperative and early postoperative period and leads to an unacceptably high post-transplant mortality rate. Currently, there are available effective drugs that can reduce pressure in the pulmonary system and thus allow liver transplantation even in patients with severe portopulmonary hypertension.
Aim:
To compare the prevalence of POHP in our liver transplant population with published data and to evaluate the outcome of patients who underwent OLTx with treated moderate and severe
portopulmonary hypertension.
Methodology:
We retrospectively analysed the results of pre-transplant examinations of patients who underwent OLTx in IKEM in 2008–2018.
Results:
Totally 890 patients with chronic liver disease underwent liver transplantation in IKEM during the reference period, of which 729 had clinically expressed portal hypertension syndrome. POPH was confirmed in 6 patients, 4 pre-transplant, 2 closely postoperative (0.82% of patients with portal hypertension). Five of them had a serious form of the disease. Despite specific peritransplantation treatment, two out of five patients died (40%) within 6 months after transplantation.
Conclusion:
The prevalence of moderate or severe POHP in our set of transplant candidates was low. The diagnosis of moderate and severe POHP was, despite the treatment, burdened by significant mortality in the early post-transplant period.

Key words
hypertension pulmonary – hypertension portal – prevalence – liver transplantation – therapeutics

Keywords

portal hypertension, prevalence, liver transplantation, treatment

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