Pulmonary complications and mortality after liver transplant.
OBJECTIVE
Pulmonary complications after liver transplant significantly affect mortality and morbidity; however, their relation has not been clearly established. We sought to determine pulmonary complications during the early and late term after liver transplant and identify risk factors for mortality.


METHODS
At our institution, 130 liver transplant patients (mean age, 40.1 -/+ 14.6 years; 71.1% male) were retrospectively evaluated, and 114 adult orthotopic liver transplant patients were included. Cause of liver disease, pulmonary function test results, arterial blood gas analyses, surgery duration, length of stay in the intensive care unit and the hospital, pulmonary complications, and mortality causes were noted.


RESULTS
Pulmonary complications were detected in 48 patients (42.1%), pneumonia in 24 patients (21.1%), and pleural effusion in 21 patients (18.4%). Development of pulmonary complications was found to be significantly related to survival (P = .001). Fifty-two patients (45.6%) were smokers, a significant predictor of pulmonary complications (P = .03). There was no relation between pulmonary function test results and orthodeoxia and pulmonary complications and mortality. Early and late survival rates were significantly lower in patients in whom a microorganism was isolated on deep tracheal aspirate culture, while early survival was significantly reduced in the presence of a pleural effusion (P < .005).


CONCLUSIONS
Pulmonary complications after liver transplant are common. Care must be taken to determine preoperative risk factors, and patients should be observed closely for development of respiratory complications after liver transplant.
Bozbas
Serife Savas
SS
Department of Pulmonary Medicine, Baskent University Faculty of Medicine, Ankara, Turkey. serifesb@gmail.com
Eyuboglu
Fusun Oner
FO
Ozturk Ergur
Figen
F
Gullu Arslan
Nevra
N
Sevmis
Sinasi
S
Karakayali
Hamdi
H
Haberal
Mehmet
M