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Outcome of liver transplantation for hepatopulmonary syndrome: a Eurotransplant experience

Sarah Raevens, Xavier Rogiers, Anja Geerts, Xavier Verhelst, Undine Samuel, Marieke van Rosmalen, Gabriela Berlakovich, Jean Delwaide, Olivier Detry, Frank Lehner, Jens Mittler, Silvio Nadalin, Frederik Nevens, Jacques Pirenne, Fuat Saner, Stefan Schneeberger, Dirk Stippel, Jerovšek Marjana Turk, Mathe Zoltan, Roberto Ivan Troisi, Hans Van Vlierberghe, Isabelle Colle
European Respiratory Journal 2019 53: 1801096; DOI: 10.1183/13993003.01096-2018
Sarah Raevens
Dept of Gastroenterology and Hepatology, Ghent University Hospital, Ghent University, Ghent, Belgium
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Xavier Rogiers
Dept of General, Hepatobiliary and Liver Transplantation Surgery, Ghent University Hospital, Ghent University, Ghent, BelgiumEurotransplant, Leiden, The Netherlands
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Anja Geerts
Dept of Gastroenterology and Hepatology, Ghent University Hospital, Ghent University, Ghent, Belgium
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Xavier Verhelst
Dept of Gastroenterology and Hepatology, Ghent University Hospital, Ghent University, Ghent, Belgium
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Undine Samuel
Eurotransplant, Leiden, The Netherlands
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Marieke van Rosmalen
Eurotransplant, Leiden, The Netherlands
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Gabriela Berlakovich
Division of Transplantation, Dept of Surgery, Medical University of Vienna, Vienna, Austria
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Jean Delwaide
Dept of Gastroenterology and Hepatology, CHU Liège, University of Liège, Liège, Belgium
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Olivier Detry
Dept of Abdominal Surgery and Transplantation, CHU Liège, University of Liège, Liège, Belgium
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  • ORCID record for Olivier Detry
Frank Lehner
General, Visceral and Transplant Surgery, Hannover Medical School, Hannover, Germany
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Jens Mittler
Dept of General, Visceral, and Transplant Surgery, University Medical Center Mainz, Mainz, Germany
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Silvio Nadalin
Dept of General, Visceral and Transplant Surgery, University Hospital Tübingen, Tübingen, Germany
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Frederik Nevens
Dept of Gastroenterology and Hepatology, University Hospitals KU Leuven, Leuven, Belgium
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Jacques Pirenne
Abdominal Transplant Surgery, University Hospitals KU Leuven, Leuven, Belgium
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Fuat Saner
Dept of General, Visceral and Transplant Surgery, University Hospital Essen, Essen, Germany
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Stefan Schneeberger
Dept of Visceral Transplant and Thoracic Surgery, Medical University Innsbruck, Innsbruck, Austria
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Dirk Stippel
Division of Transplantation Surgery, Dept of General, Visceral and Cancer Surgery, Transplant Center Cologne, University of Cologne, Cologne, Germany
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Jerovšek Marjana Turk
Dept of Gastroenterology and Hepatology, University Medical Center Ljubljana, Ljubljana, Slovenia
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Mathe Zoltan
Dept of Transplantation and Surgery, Semmelweis University Budapest, Budapest, Hungary
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Roberto Ivan Troisi
Dept of General, Hepatobiliary and Liver Transplantation Surgery, Ghent University Hospital, Ghent University, Ghent, BelgiumDept of Clinical Medicine and Surgery, Federico II University Naples, Naples, Italy
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Hans Van Vlierberghe
Dept of Gastroenterology and Hepatology, Ghent University Hospital, Ghent University, Ghent, Belgium
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Isabelle Colle
Dept of Gastroenterology and Hepatology, Ghent University Hospital, Ghent University, Ghent, Belgium
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Extract

Hepatopulmonary syndrome (HPS) is a pulmonary vascular complication of liver disease that affects up to 30% of patients with cirrhosis [1]. Intrapulmonary vascular dilatations and shunts result in gas exchange abnormalities, ranging from elevated alveolar–arterial oxygen gradients with no hypoxaemia to very severe hypoxaemia [1, 2]. Currently, liver transplantation (LT) is the only treatment option [3]. The Model for End-Stage Liver Disease (MELD) is a scoring system for assessing liver disease severity that has been validated to predict the 3-month waiting list mortality and is used by Eurotransplant for prioritising allocation of liver transplants [4]. However, this score poorly predicts overall and post-transplant survival, and does not take into account complications that affect outcomes independent of liver disease severity [5].

Abstract

Equal overall survival among liver transplantation candidates supports current prioritisation policy for severe hepatopulmonary syndrome http://ow.ly/4SQS30mwOtK

Acknowledgements

The authors thank Roos Colman (Dept of Public Health, Biostatistics Unit, Ghent University, Ghent, Belgium) for her assistance in the statistical analysis of the data, the Eurotransplant representatives for supporting the organisation of this work and all Eurotransplant liver transplantation centres for providing data to the Eurotransplant registry.

Footnotes

  • Conflict of interest: S. Raevens has nothing to disclose.

  • Conflict of interest: X. Rogiers has nothing to disclose.

  • Conflict of interest: A. Geerts has nothing to disclose.

  • Conflict of interest: X. Verhelst has nothing to disclose.

  • Conflict of interest: U. Samuel has nothing to disclose.

  • Conflict of interest: M. van Rosmalen has nothing to disclose.

  • Conflict of interest: G. Berlakovich has nothing to disclose.

  • Conflict of interest: J. Delwaide has nothing to disclose.

  • Conflict of interest: O. Detry has nothing to disclose.

  • Conflict of interest: F. Lehner has nothing to disclose.

  • Conflict of interest: J. Mittler has nothing to disclose.

  • Conflict of interest: S. Nadalin has nothing to disclose.

  • Conflict of interest: F. Nevens reports receiving grants from Roche, Astellas and Sandoz, grants and consultancy fees from BMS, CAF, MSD, TwinPharma and Ipsen, and consultancy fees from Gilead, Novartis, Abbvie, Promethera Biosciences, Durect, Ferring, Gore, Cook Medical, Biotest and Intercept, outside the submitted work.

  • Conflict of interest: J. Pirenne has nothing to disclose.

  • Conflict of interest: F. Saner has nothing to disclose.

  • Conflict of interest: S. Schneeberger reports being a member of an expert group and a consultant for Merck; being a member of an expert group and a speaker for Astellas; receiving grants, and being a member of an expert group and a consultant for Chiesi; being a member of an expert group, a speaker and a consultant for Teva; being a speaker for Novartis; and receiving grants from Sandoz, all outside the submitted work.

  • Conflict of interest: D. Stippel has nothing to disclose.

  • Conflict of interest: M. Turk Jerovšek has nothing to disclose.

  • Conflict of interest: M. Zoltan has nothing to disclose.

  • Conflict of interest: R.I. Troisi has nothing to disclose.

  • Conflict of interest: H. Van Vlierberghe has nothing to disclose.

  • Conflict of interest: I. Colle reports consultancy for Promethera outside the submitted work.

  • Support statement: S. Raevens is paid by a fellowship from the Research Foundation – Flanders (11W5715N). Funding information for this article has been deposited with the Crossref Funder Registry.

  • Received June 12, 2018.
  • Accepted October 22, 2018.
  • Copyright ©ERS 2019
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Outcome of liver transplantation for hepatopulmonary syndrome: a Eurotransplant experience
Sarah Raevens, Xavier Rogiers, Anja Geerts, Xavier Verhelst, Undine Samuel, Marieke van Rosmalen, Gabriela Berlakovich, Jean Delwaide, Olivier Detry, Frank Lehner, Jens Mittler, Silvio Nadalin, Frederik Nevens, Jacques Pirenne, Fuat Saner, Stefan Schneeberger, Dirk Stippel, Jerovšek Marjana Turk, Mathe Zoltan, Roberto Ivan Troisi, Hans Van Vlierberghe, Isabelle Colle
European Respiratory Journal Feb 2019, 53 (2) 1801096; DOI: 10.1183/13993003.01096-2018

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Outcome of liver transplantation for hepatopulmonary syndrome: a Eurotransplant experience
Sarah Raevens, Xavier Rogiers, Anja Geerts, Xavier Verhelst, Undine Samuel, Marieke van Rosmalen, Gabriela Berlakovich, Jean Delwaide, Olivier Detry, Frank Lehner, Jens Mittler, Silvio Nadalin, Frederik Nevens, Jacques Pirenne, Fuat Saner, Stefan Schneeberger, Dirk Stippel, Jerovšek Marjana Turk, Mathe Zoltan, Roberto Ivan Troisi, Hans Van Vlierberghe, Isabelle Colle
European Respiratory Journal Feb 2019, 53 (2) 1801096; DOI: 10.1183/13993003.01096-2018
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