Analysis of risk factors of early pulmonary complications after orthotopic liver transplantation: a report of 313 cases / 中华器官移植杂志

ABSTRACT

Objective:To explore the effects of donor, basic recipient characteristics and intraoperative findings before orthotopic liver transplantation(OLT)on postoperative pulmonary complications and the influence of postoperative pulmonary complications on postoperative outcomes and long-term survival of patients.Methods:From January 2016 to December 2019, clinical data were retrospectively reviewed for 313 OLT recipients at First Affiliated Hospital, Nanjing Medical University.According to clinical manifestations, laboratory parameters and imaging findings within 7 days post-operation, they were divided into two groups of with and without postoperative pulmonary complications.Univariate and multivariate Logistic regression analyses were performed for general parameters of donors/recipients and perioperative variables of recipients in two groups.And Kaplan-Meier survival analysis was conducted for postoperative survival of two groups.Results:Multiariate Logistic regression analysis indicated that age, concurrent chronic diseases, low preoperative platelet count, intraoperative massive bleeding(>1 500 ml)and severe hypotension after perfusion were all independent risk factors for postoperative pulmonary complications.Compared with those without postoperative pulmonary complications, intensive care unit(ICU)stay, postoperative mechanical ventilation duration and hospital stay were significantly prolonged in patients with postoperative pulmonary complications.And rate of re-intubation, incidence of acute kidney injury and hospital mortality spiked markedly( P<0.05). Among OLT patients with benign liver diseases, overall survival rate of patients without postoperative pulmonary complications was significantly better than that of those with postoperative pulmonary complications( P<0.05). Conclusions:Age, concurrent chronic diseases, low preoperative platelet count, massive intraoperative bleeding(>1 500 ml)and severe hypotension after perfusion boost the risks of early postoperative pulmonary complications and adversely affect the outcomes of OLT recipients.