Nobuhisa Hagiwara
   Department   Other, Other
   Position  
Article types Original article
Language English
Peer review Non peer reviewed
Title Portopulmonary hypertension and the risk of high right ventricular systolic pressure in liver transplant candidates.
Journal Formal name:PloS one
Abbreviation:PLoS One
ISSN code:19326203/19326203
Domestic / ForeginForegin
Volume, Issue, Page 17(4),pp.e0267125
Author and coauthor HAYASHI Ryoko, KOGISO Tomomi*, KIKUCHI Noriko, YAMAMOTO Kana, NAKAMURA Shinichi, EGAWA Hiroto, HAGIWARA Nobuhisa, TOKUSHIGE Katsutoshi
Publication date 2022/04
Summary AIM:Portopulmonary hypertension (PoPH) is a rare and serious complication of liver cirrhosis and portal hypertension that can interfere with liver transplantation (LT). We evaluated the prevalence of PoPH and the clinical features of right ventricular systolic pressure (RVSP), which is equivalent to pulmonary artery systolic pressure, in LT candidates.METHODS:This was a single-center retrospective study. A total of 157 Japanese patients with decompensated liver cirrhosis or portal hypertension (76 men, median age = 52 years [range: 18-68 years]) were enrolled. The relationships between RVSP and clinical parameters, and the prevalence of PoPH in LT candidates, were evaluated.RESULTS:The cardiological parameters were as follows: brain natriuretic peptide (BNP), 39.1 (4.0-780.5) pg/mL; RVSP, 31.2 (16.0-122.4) mmHg; ejection fraction, 58% (28-72%); and mean peak tricuspid regurgitation velocity, 2.3 (1.5-5.3) m/s. The RVSP was significantly higher in females (p = 0.02) and primary biliary cholangitis (PBC) patients (p = 0.01), and was weakly correlated with the BNP level (r = 0.40, p = 0.01). For RVSPs of < 36 and ≥ 36 mmHg, the 5-year survival rates were 36.1% versus 34.1%, and 85.4% versus 85.3%, in non-LT and LT cases, respectively (p = 0.47 and 0.69, respectively). Among six patients with an RVSP ≥ 50 mmHg, three (1.9%) were diagnosed with PoPH and treated with vasodilators.CONCLUSIONS:PoPH was observed in 3 cases (1.9%) in 157 LT candidates. In patients with suspected mild pulmonary hypertension (RVSP, 36 - 50 mmHg), LT was successfully performed.
DOI 10.1371/journal.pone.0267125
PMID 35439259