Department of Internal Medicine, Lahey Hospital and Medical Center, Burlington, MA, USA.
Department of Gastroenterology, Lahey Hospital and Medical Center, Burlington, MA, USA.
Expert Rev Gastroenterol Hepatol. 2023 Feb;17(2):199-204. doi: 10.1080/17474124.2023.2166929. Epub 2023 Jan 9.
Hepatic hydrothorax (HH) is associated with a poor prognosis. Liver transplant (LT) is the best treatment modality. We aim to assess post-LT morbidity and mortality in patients with cirrhosis and HH.
Adult patients with cirrhosis, who underwent LT at our institution from 2015 to 2020, were retrospectively reviewed. Baseline data was obtained at the time of LT. Patients were followed from baseline until the last follow-up or death. Censoring occurred at the time of the last follow-up or death, whichever occurred earlier. Cumulative incidence of outcomes was determined by the Kaplan-Meier method. Short-term post-operative complications were compared between both groups as well.
428 patients had a LT, of which 72 (16.8%) had HH. Most of the baseline characteristics were similar between patients with and without HH; however, patients in the HH group had a higher proportion of pre-operative history of ascites and hepatic encephalopathy. Pre-operative HH was not significantly associated with post-LT mortality (Hazard ratio 1.12, 95% confidence interval 0.54-2.32; P-value 0.76). Patients had similar short-term post-operative complications between both groups.
LT is an excellent therapeutic option for patients with cirrhosis and HH, with excellent long-term survival without increased morbidity.
肝性胸水（HH）与预后不良相关。肝移植（LT）是最佳治疗方式。我们旨在评估肝硬化伴 HH 患者 LT 后的发病率和死亡率。
回顾性分析 2015 年至 2020 年在我院行 LT 的成年肝硬化患者。在 LT 时获取基线数据。患者从基线随访至最后一次随访或死亡。以最后一次随访或死亡时间为准进行删失。通过 Kaplan-Meier 法确定结局的累积发生率。比较两组患者的短期术后并发症。
428 例患者行 LT，其中 72 例（16.8%）患有 HH。HH 组和无 HH 组患者的大多数基线特征相似；然而，HH 组患者术前有腹水和肝性脑病病史的比例更高。术前 HH 与 LT 后死亡率无显著相关性（风险比 1.12，95%置信区间 0.54-2.32；P 值 0.76）。两组患者短期术后并发症相似。
LT 是肝硬化伴 HH 患者的极佳治疗选择，长期生存率高，且发病率无增加。
