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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