Abstract
Introduction and Aims: It is common to detect elevated alveolar-arterial oxygen gradient (AaO2) in patients assessed for liver transplantation(LT), although its importance prior to transplant is still unknown. The aim of the study was to analyse the impact of AaO2 in short and long-term evolution after LT.
Methods: We conducted a cohort study of patients who underwent LT for treatment of end-stage liver disease.Patients were categorized into 3 groups according to AaO2 prior to LT: normal(<15,<20 from 65 yrs);high (15-30, 20-30 from 65 yrs); and very high(>30). Kaplan-Meier survival analysis was conducted to compare survival between groups for the overall period. We controlled variables to address potential confounding.
Results: Between 2007-2018, a total of 1211 LT were performed over 1135 patients. Of these, 529 patients met the criteria. Post-LT survival at 1 year was 92.4%,92.9% and 88.3% and at 5 years of 81.4%,84.2% and 88.3% in the groups of normal,high and very high AaO2, respectively (figure). AaO2>30 mmHg prior to LT was associated with half of long-term mortality when adjusted for age, gender, body mass index(BMI), waiting list time and FEV1 pre-LT (HR 0.48;95%CI 0.24-0.97).
Conclusions: Adjusted long-term mortality after LT halved in the patients with AaO2>30. Despite this long-term protective effect, these patients may have an increased risk of short-term mortality after LT.
Footnotes
Cite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 1917.
This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2020