Outcomes of Liver Transplantation for Porto-pulmonary Hypertension in Model for End-stage Liver Disease Era

Overview

Journal Dig Dis Sci

Specialty Gastroenterology

Date 2014 Feb 22

PMID 24557576

Citations 11

Authors

Reena J Salgia

Nathan P Goodrich

Heather Simpson

Robert M Merion

Pratima Sharma

Affiliations

Soon will be listed here.

Abstract

Unlabelled: Porto-pulmonary hypertension (POPH), once considered an absolute contraindication for liver transplantation (LT), has become a more accepted indication because of the evolution of treatment with prostacyclin analogues, phosphodiesterase inhibitors and endothelin receptor antagonists. An exception model for end stage liver disease (MELD) score of 22 is assigned to candidates with documentation of effective treatment. We examined the post-transplant outcomes of patients who received LT for POPH with exception.

Methods: Scientific Registry of Transplant Recipients data on 34,318 adult (≥ 18 years) deceased donor LT recipients transplanted between March 1, 2002 and August 31, 2010 were reviewed. The diagnosis of POPH was ascertained from MELD exception forms. Patients were followed from the time of transplant until the earlier occurrence of death or end of the follow-up period. Cox regression was used to evaluate the predictors of post-LT mortality and graft failure.

Results: During the study period, 34,318 patients received deceased donor LT. Seventy eight out of 34,318 patients were transplanted for POPH with MELD exception. The 1-year adjusted risks of patient death and graft failure for patients transplanted under exception rules for POPH were significantly higher than with POPH adult recipients who did not receive exception points (death:hazard ratio [HR] = 2.25, p = 0.005 and graft failure HR = 1.96, p = 0.012).

Conclusions: This study of national data suggests that treated POPH continues to be associated with inferior early post-transplant outcomes.

Citing Articles

Portopulmonary hypertension: Current developments and future perspectives.

Xu H, Cheng B, Wang R, Ding M, Gao Y Liver Res. 2025; 6(1):10-20.

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Emergency ECMO Deployment During Liver Transplantation in Portopulmonary Hypertension Patients.

Da Costa Rodrigues J, Gazarian C, Maillard J, Albu G, Assouline B, Lador F Am J Case Rep. 2025; 26:e946268.

PMID: 39891381 PMC: 11791688. DOI: 10.12659/AJCR.946268.

Portopulmonary Hypertension: An Updated Review.

Jasso-Baltazar E, Pena-Arellano G, Aguirre-Valadez J, Ruiz I, Papacristofilou-Riebeling B, Jimenez J Transplant Direct. 2023; 9(8):e1517.

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Hemodynamic and Clinical Response to Liver Transplantation in Children and Young Adults POPH Patients.

Baba S, Ogawa E, Akagi K, Matsuda K, Hirata T, Okamoto T Pediatr Cardiol. 2023; 45(5):1142-1150.

PMID: 36754885 DOI: 10.1007/s00246-023-03121-0.

Current Approaches in the Allocation of Liver Transplantation.

Ionescu V, Diaconu C, Bungau S, Jinga V, Gheorghe G J Pers Med. 2022; 12(10).

PMID: 36294801 PMC: 9605642. DOI: 10.3390/jpm12101661.

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