title: Perioperative morbidity and mortality of total hip replacement in liver transplant recipients:  a 7-year single-center experience.
abstract: OBJECTIVE
  This study aims to evaluate perioperative mortality and morbidity after total hip replacement in liver transplant recipients and suggesting safety guidelines.
  
  
  BACKGROUND
  Hip replacement surgery is one of the most common elective surgeries even for organ transplant recipients. However, there is a paucity of literature addressing the morbidity and complications of hip replacement surgery for liver transplant recipients.
  
  
  METHODS
  We analyzed retrospectively 33 arthroplasty cases in 20 liver transplant recipients carried out in a single center from 2005 to 2011. All perioperative clinical and laboratory data were evaluated together with early and late morbidity and mortality.
  
  
  RESULTS
  Of 2253 liver transplant recipients, 20 (0.9%) patients underwent 33 total hip arthroplasties. Thirty-two arthroplasties were performed for avascular necrosis of the femoral head, whereas only one was performed for osteoarthritis. There was no death, liver failure, or infection within 30 days after surgery. Three patients showed elevated liver enzyme more than 5 times the normal value, but it eventually decreased to normal within 1 week. Of 33 cases of arthroplasty, postoperative blood transfusion was needed in 14 cases with 1 case receiving more than 4 U. On long-term follow-up, no patients have developed periprosthetic fracture, implant loosening, or liver failure. All patients showed good to excellent postoperative Harris hip score.
  
  
  CONCLUSIONS
  In this series, we can infer that hip replacement surgery in liver transplantation patients is safe and gives a reliably good result. Some preoperative conditions should be obtained to reduce postoperative morbidity.
authors.affiliation: Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Iman
authors.initials: I
authors.lastname: Aminata
authors.forename: Soo-Ho
authors.initials: SH
authors.lastname: Lee
authors.forename: Jae-Suk
authors.initials: JS
authors.lastname: Chang
authors.forename: Choon-Sung
authors.initials: CS
authors.lastname: Lee
authors.forename: Jae-Myeung
authors.initials: JM
authors.lastname: Chun
authors.forename: Jin-Woong
authors.initials: JW
authors.lastname: Park
authors.forename: Aditya
authors.initials: A
authors.lastname: Pawaskar
authors.forename: In-Ho
authors.initials: IH
authors.lastname: Jeon
mesh_terms: D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000401:mortality; D001219:Aspartate Aminotransferases / Q000097:blood; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D008111:Liver Function Tests; D016031:Liver Transplantation / Q000009:adverse effects* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D059035:Perioperative Period; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D056910:Republic of Korea; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D015415:Biomarkers; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase