Impact of hypoxemia on pediatric liver transplantation for hepatopulmonary syndrome.

Autor: Turine Neto P; Hepatology and Liver Transplantation, Hospital Sírio-Libanês, São Paulo, Brazil.; Hepatology and Liver Transplantation A. C. Camargo Cancer Center, São Paulo, Brazil.; Hospital Municipal Infantil Menino Jesus, São Paulo, Brazil., Seda Neto J; Hepatology and Liver Transplantation, Hospital Sírio-Libanês, São Paulo, Brazil.; Hepatology and Liver Transplantation A. C. Camargo Cancer Center, São Paulo, Brazil.; Hospital Municipal Infantil Menino Jesus, São Paulo, Brazil., da Fonseca EA; Hepatology and Liver Transplantation, Hospital Sírio-Libanês, São Paulo, Brazil.; Hepatology and Liver Transplantation A. C. Camargo Cancer Center, São Paulo, Brazil.; Hospital Municipal Infantil Menino Jesus, São Paulo, Brazil., Porta G; Hepatology and Liver Transplantation, Hospital Sírio-Libanês, São Paulo, Brazil.; Hepatology and Liver Transplantation A. C. Camargo Cancer Center, São Paulo, Brazil.; Hospital Municipal Infantil Menino Jesus, São Paulo, Brazil., Pugliese R; Hepatology and Liver Transplantation, Hospital Sírio-Libanês, São Paulo, Brazil.; Hepatology and Liver Transplantation A. C. Camargo Cancer Center, São Paulo, Brazil.; Hospital Municipal Infantil Menino Jesus, São Paulo, Brazil., Benavides MAR; Hepatology and Liver Transplantation, Hospital Sírio-Libanês, São Paulo, Brazil.; Hepatology and Liver Transplantation A. C. Camargo Cancer Center, São Paulo, Brazil.; Hospital Municipal Infantil Menino Jesus, São Paulo, Brazil., Vincenzi R; Hepatology and Liver Transplantation, Hospital Sírio-Libanês, São Paulo, Brazil.; Hepatology and Liver Transplantation A. C. Camargo Cancer Center, São Paulo, Brazil.; Hospital Municipal Infantil Menino Jesus, São Paulo, Brazil., Roda KMO; Hepatology and Liver Transplantation, Hospital Sírio-Libanês, São Paulo, Brazil.; Hepatology and Liver Transplantation A. C. Camargo Cancer Center, São Paulo, Brazil.; Hospital Municipal Infantil Menino Jesus, São Paulo, Brazil., Danesi VLB; Hepatology and Liver Transplantation, Hospital Sírio-Libanês, São Paulo, Brazil.; Hepatology and Liver Transplantation A. C. Camargo Cancer Center, São Paulo, Brazil.; Hospital Municipal Infantil Menino Jesus, São Paulo, Brazil., Hirschfeld APM; Hepatology and Liver Transplantation, Hospital Sírio-Libanês, São Paulo, Brazil.; Hepatology and Liver Transplantation A. C. Camargo Cancer Center, São Paulo, Brazil.; Hospital Municipal Infantil Menino Jesus, São Paulo, Brazil., Feier FH; Hepatology and Liver Transplantation, Hospital Sírio-Libanês, São Paulo, Brazil.; Hospital Municipal Infantil Menino Jesus, São Paulo, Brazil., Chapchap P; Hepatology and Liver Transplantation, Hospital Sírio-Libanês, São Paulo, Brazil.; Hospital Municipal Infantil Menino Jesus, São Paulo, Brazil., Miura IK; Hepatology and Liver Transplantation, Hospital Sírio-Libanês, São Paulo, Brazil.; Hepatology and Liver Transplantation A. C. Camargo Cancer Center, São Paulo, Brazil.; Hospital Municipal Infantil Menino Jesus, São Paulo, Brazil.
Jazyk: angličtina
Zdroj: Pediatric transplantation [Pediatr Transplant] 2021 Aug; Vol. 25 (5), pp. e13968. Date of Electronic Publication: 2021 Feb 16.
DOI: 10.1111/petr.13968
Abstrakt: 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.
(© 2021 Wiley Periodicals LLC.)
Databáze: MEDLINE
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