The impact of echocardiography on predicting refractory ascites following living-donor liver transplantation

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  • NAKAYAMA Yuki
    Department of Surgery and Science, Graduate School of Medical Science, Kyushu University
  • ITOH Shinji
    Department of Surgery and Science, Graduate School of Medical Science, Kyushu University
  • TOSHIMA Takeo
    Department of Surgery and Science, Graduate School of Medical Science, Kyushu University
  • ISHIKAWA Takuma
    Department of Surgery and Science, Graduate School of Medical Science, Kyushu University
  • TOSHIDA Katsuya
    Department of Surgery and Science, Graduate School of Medical Science, Kyushu University
  • TSUTSUI Yuriko
    Department of Surgery and Science, Graduate School of Medical Science, Kyushu University
  • IZUMI Takuma
    Department of Surgery and Science, Graduate School of Medical Science, Kyushu University
  • ISEDA Norifumi
    Department of Surgery and Science, Graduate School of Medical Science, Kyushu University
  • YOSHIYA Shohei
    Department of Surgery and Science, Graduate School of Medical Science, Kyushu University
  • NINOMIYA Mizuki
    Department of Surgery and Science, Graduate School of Medical Science, Kyushu University
  • YOSHIZUMI Tomoharu
    Department of Surgery and Science, Graduate School of Medical Science, Kyushu University

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  • 心エコー検査による生体肝移植術後難治性腹水の術前リスク評価

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<p>【Objective】 Postoperative prolonged ascites is a common complication after living-donor liver transplantation (LDLT). However, there is little evidence regarding the circulatory indicators as risk factors for ascites after LDLT. The aim was to evaluate the impact of trans tricuspid pressure gradient (TRPG) on postoperative prolonged ascites.</p><p>【Design】 Case-series.</p><p>【Method】 We collected data from 268 recipients who underwent LDLT for liver failure between 2008 and 2022. We excluded 7 recipients who died within 30 days after LDLT and divided the remainer into two groups by TRPG value.</p><p>【Results】 Of the 261 patients with liver failure, 98 (37.7%) were classified as the high TRPG group and 163 (62.3%) comprised the low TRPG group. There was a significant difference in the rate of intractable ascites between the two groups, but no significant difference in overall survival (OS). After PSM, univariate analysis detected two risk factors, high TRPG value and ascites at laparotomy ≥5000 mL. In the multivariate analysis, high TRPG value (P=0.0345, OR=11.4, 95% CI 1.19-108) and ascites at laparotomy ≥5000 (mL) (P=0.0067, OR=10.2, 95% CI 1.91-54.8) were identified as independent risk factors.</p><p>【Conclusion】 Preoperative TRPG elevation is a risk for prolonged ascites after LDLT, and it can be valuable to measure TRPG in the preoperative condition assessment.</p>

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