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Impact of hypoxemia on pediatric liver transplantation for hepatopulmonary syndrome
Author(s) -
Turine Neto Plínio,
Seda Neto João,
Fonseca Eduardo Antunes,
Porta Gilda,
Pugliese Renata,
Benavides Marcel Albeiro Ruiz,
Vincenzi Rodrigo,
Roda Karina Moreira Oliveira,
Danesi Vera Lúcia Baggio,
Hirschfeld Adriana Porta Miche,
Feier Flavia Heinz,
Chapchap Paulo,
Miura Irene Kazue
Publication year - 2021
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/petr.13968
Subject(s) - medicine , hypoxemia , hepatopulmonary syndrome , weaning , perioperative , liver transplantation , cirrhosis , transplantation , retrospective cohort study , gastroenterology , surgery , pediatrics
Background The treatment of choice for patients with cirrhosis and HPS is LT. The clinical manifestations associated with hypoxemia result in limitations and a poor health‐related quality of life of affected patients. The present report aims to study the differences in outcomes between patients with PaO 2 < 50 mm Hg and those with PaO 2 ≥ 50 mm Hg. Methods This was a retrospective study of 21 patients under 18 years of age conducted from 2001 to 2018; the patients were divided into 2 groups: G1—PaO 2 ≥ 50 mm Hg, 11 patients, and G2—PaO 2 < 50 mm Hg, 10 patients. Demographic, clinical, laboratory, and perioperative data; outcome variables; and post‐transplant survival were compared between the groups. Results In total, 2/11 (18.2%) patients in G1 and 8/10 (80%) patients in G2 required supplemental oxygen therapy at home ( P = .005). Patients in G2 required prolonged MV (median 8.5 days in G2 vs 1 day in G1, P = .015) and prolonged ICU and hospital stays ( P = .002 and P = .001, respectively). Oxygen weaning time was longer in G2 (median 127.5 days) than in G1 (median 3 days; P = .004). One (9.1%) patient in G1 and three (30%) patients in G2 died ( P = .22). The survival at 90 months was 90.9% in G1 and 70% in G2 ( P = .22). Conclusion The survival between groups was similar. Patients with very severe HPS required a longer MV time, longer ICU and hospital stays, and a longer O 2 weaning time than those with mild, moderate, or severe HPS.