Abstract
Purpose
Uncontrollable hepatic hydrothorax and massive ascites (H&MA) requiring preoperative drainage are sometimes encountered in liver transplantation (LT). We retrospectively analyzed the characteristics of such patients and the impact of H&MA on the postoperative course.
Methods
We evaluated 237 adult patients who underwent LT in our institute between April 2006 and October 2010.
Results
Recipients with uncontrollable H&MA (group HA: n = 36) had more intraoperative bleeding, higher Child–Pugh scores, lower serum albumin concentrations and higher blood urea nitrogen concentrations than those without uncontrollable H&MA (group C: n = 201). They were also more likely to have preoperative hepatorenal syndrome and infections. The incidence of postoperative bacteremia was higher (55.6 vs. 46.7 %, P = 0.008) and the 1- and 3-year survival rates were lower (1 year: 58.9 vs. 82.9 %; 3 years: 58.9 vs. 77.7 %; P = 0.003) in group HA than in group C. The multivariate proportional regression analyses revealed that uncontrollable H&MA and the Child–Pugh score were independent risk factors for the postoperative prognosis.
Conclusions
Postoperative infection control may be an important means of improving the outcome for patients with uncontrollable H&MA undergoing LT, and clinicians should strive to perform surgery before H&MA becomes uncontrollable.
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The authors have no conflicts of interest to declare in association with this study.
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Endo, K., Iida, T., Yagi, S. et al. Impact of preoperative uncontrollable hepatic hydrothorax and massive ascites in adult liver transplantation. Surg Today 44, 2293–2299 (2014). https://doi.org/10.1007/s00595-014-0839-y
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DOI: https://doi.org/10.1007/s00595-014-0839-y