Early respiratory complications after liver transplantation

Table 1 Common preoperative risk factors for post-orthotopic liver transplantation pulmonary complications

Recipient’s age[2,8]

Female sex[5]

Smoking history[3]

Severity of liver dysfunction[2] (Child-Pugh class[5], MELD score[12,43])

Cirrhotic encephalopathy

Cerebral dysfunction[5]

Acute renal failure

Emphysema[3]

High systolic pulmonary artery pressure[3]

Hypoxia, orthodeoxia[3]

Hepatopulmonary syndrome

Pre-existing pulmonary abnormalities[1]:

Intrinsic cardiopulmonary disease: chronic obstructive pulmonary disease, congestive heart failure, pneumonia, asthma

Specific to liver disease: association with specific liver diseases (alpha-1 antitrypsin deficiency, primary biliary cirrhosis), fluid retention com plicating portal hypertension (ascites, hepatic hydrothorax), pulmo- nary vascular abnormalities (hepatopulmonary syndrome, portopul monary hypertension)

Evidence of a restrictive pulmonary syndrome[2]

Abnormal spirometry findings[3]

Preoperative ventilator support[6]

Severe preoperative respiratory failure requiring mechanical ventilation[8,9]

Higher value of INR[2]

Preexisting diabetes mellitus[6,7]

Impaired renal function[6]

Preoperative MARS use[6]

Deceased donor source of organ transplantation[6]

MELD: Model End Stage Liver Disease; INR: International normalised ratio; MARS: Molecular adsorbent re-circulating system.