Savaş Bozbaş Şerife, Eroğlu Serpil, Öner Eyüboğlu Füsun, Moray Gökhan, Haberal Mehmet
From the Department of Pulmonary Diseases, Başkent University Faculty of Medicine, Ankara, Turkey.
Exp Clin Transplant. 2015 Nov;13 Suppl 3:115-9. doi: 10.6002/ect.tdtd2015.P65.
Pulmonary hypertension is a common finding in chronic liver disease patients that has prognostic significance. In this study, we aimed to evaluate the prevalence and severity of pulmonary hypertension in patients undergoing orthotopic liver transplant. We also evaluated pulmonary artery pressure changes after transplant surgery.
The records of adult patients with chronic liver disease who underwent orthotopic liver transplant at our center between 2004 and 2015 were retrospectively evaluated. Clinical and demographic variables and laboratory data were noted. Transthoracic Doppler echocardiographic examination reports were obtained. Using continuous-wave Doppler examination, systolic pulmonary artery pressure values were calculated. Pulmonary hypertension was defined as systolic pulmonary artery pressure ≥ 30 mm Hg. Among 208 adult patients who underwent orthotopic liver transplant, 203 who had Doppler echocardiographic examination were enrolled.
The mean age of patients was 42.1 ± 14.1 years (range, 16-67 y), and 143 (70.4%) were men. During preoperative assessment, pulmonary hypertension was identified in 47 patients (23.2%), of whom 10 displayed systolic pulmonary artery pressure > 50 mm Hg. Compared with preoperative values of systolic pulmonary artery pressure (46.8 ± 8.4 mm Hg), a significant reduction in mean values (to 39.3 ± 13.3 mm Hg) was observed postoperatively (P = .007).
The findings of this study indicate that pulmonary hypertension is a common finding in adult chronic liver disease patients undergoing orthotopic liver transplant. A significant improvement occurs in systolic pulmonary artery pressure values following transplant surgery. Regarding the prevalence and prognostic significance of pulmonary hypertension, all patients with chronic liver disease should be evaluated with transthoracic Doppler echocardiography before transplant.
肺动脉高压是慢性肝病患者的常见表现，具有预后意义。在本研究中，我们旨在评估原位肝移植患者中肺动脉高压的患病率和严重程度。我们还评估了移植手术后肺动脉压力的变化。
回顾性评估2004年至2015年间在我们中心接受原位肝移植的成年慢性肝病患者的记录。记录临床和人口统计学变量以及实验室数据。获取经胸多普勒超声心动图检查报告。使用连续波多普勒检查计算收缩期肺动脉压值。肺动脉高压定义为收缩期肺动脉压≥30mmHg。在208例接受原位肝移植的成年患者中，纳入了203例进行了多普勒超声心动图检查的患者。
患者的平均年龄为42.1±14.1岁（范围16 - 67岁），其中143例（70.4%）为男性。在术前评估中，47例患者（23.2%）被诊断为肺动脉高压，其中10例收缩期肺动脉压>50mmHg。与术前收缩期肺动脉压值（46.8±8.4mmHg）相比，术后平均值显著降低（降至39.3±13.3mmHg）（P = 0.007）。
本研究结果表明，肺动脉高压在接受原位肝移植的成年慢性肝病患者中很常见。移植手术后收缩期肺动脉压值有显著改善。关于肺动脉高压的患病率和预后意义，所有慢性肝病患者在移植前都应进行经胸多普勒超声心动图评估。
