Abstract：
BACKGROUND: Severe early complications are common after liver transplantation (LT) and are a key determinant of LT-related morbidity and mortality. The aim of this study was to assess whether lung function measured in the pre-operative period predicted complicated outcomes in the first month after LT.
METHODS: Patients with mild-to-moderate liver disease (Model for End stage Liver Disease-MELD score≤30) who underwent LT between October 2015 and May 2020 in a single centre were retrospectively included. The primary endpoint was the occurrence of severe early complications after LT defined by mechanical ventilation duration > 2 days or length of ICU stay > 7 days or reintubation or death < 1 month after LT.
RESULTS: One hundred and twenty patients were included (age 59 [53-64] years, 72 % men). Forty patients (33 %) had early complications after LT. Measured and%predicted hemoglobin-corrected lung transfer capacity for carbon monoxide (DLCOc) were significantly lower in patients with severe early complications after LT. DLCOc was the only variable that associated independently with severe early complications by multivariate analysis. DLCOc under 16.3 ml.min-1.mmHg-1 predicted respiratory complications with a sensitivity of 67.5 % and a specificity of 62.9 %. DLCOc%pred under 61.5 % had a sensitivity of 56.8 % and a specificity of 72 %. DLCOc independently associated with forced vital capacity (FVC), pulmonary emphysema, and the muscle mass index.
CONCLUSIONS: A decrease in DLCOc indicated an increased risk of severe early complications after LT.
METHODS: Patients with mild-to-moderate liver disease (Model for End stage Liver Disease-MELD score≤30) who underwent LT between October 2015 and May 2020 in a single centre were retrospectively included. The primary endpoint was the occurrence of severe early complications after LT defined by mechanical ventilation duration > 2 days or length of ICU stay > 7 days or reintubation or death < 1 month after LT.
RESULTS: One hundred and twenty patients were included (age 59 [53-64] years, 72 % men). Forty patients (33 %) had early complications after LT. Measured and%predicted hemoglobin-corrected lung transfer capacity for carbon monoxide (DLCOc) were significantly lower in patients with severe early complications after LT. DLCOc was the only variable that associated independently with severe early complications by multivariate analysis. DLCOc under 16.3 ml.min-1.mmHg-1 predicted respiratory complications with a sensitivity of 67.5 % and a specificity of 62.9 %. DLCOc%pred under 61.5 % had a sensitivity of 56.8 % and a specificity of 72 %. DLCOc independently associated with forced vital capacity (FVC), pulmonary emphysema, and the muscle mass index.
CONCLUSIONS: A decrease in DLCOc indicated an increased risk of severe early complications after LT.
摘要：
背景：严重的早期并发症在肝移植（LT）后很常见，并且是LT相关发病率和死亡率的关键决定因素。这项研究的目的是评估术前测量的肺功能是否可以预测LT术后第一个月的复杂结局。
方法：回顾性纳入2015年10月至2020年5月在单中心接受LT的轻度至中度肝病（终末期肝病模型-MELD评分≤30）患者。主要终点是LT后严重早期并发症的发生，其定义为机械通气持续时间>2天或ICU住院时间>7天或LT后再插管或死亡<1个月。
结果：纳入120名患者（年龄59[53-64]岁，72%男性）。40例(33%)患者术后出现早期并发症。在LT术后严重早期并发症的患者中，经血红蛋白校正的一氧化碳肺转移能力（DLCOc）的测量值和预测百分比显着降低。通过多变量分析，DLCOc是唯一与严重早期并发症独立相关的变量。DLCOc低于16.3ml。min-1.mmHg-1预测呼吸系统并发症的敏感性为67.5%，特异性为62.9%。低于61.5%的DLCOc%pred具有56.8%的灵敏度和72%的特异性。DLCOc与强迫肺活量(FVC)独立相关，肺气肿,和肌肉质量指数.
结论：DLCOc降低表明LT术后严重早期并发症的风险增加。
方法：回顾性纳入2015年10月至2020年5月在单中心接受LT的轻度至中度肝病（终末期肝病模型-MELD评分≤30）患者。主要终点是LT后严重早期并发症的发生，其定义为机械通气持续时间>2天或ICU住院时间>7天或LT后再插管或死亡<1个月。
结果：纳入120名患者（年龄59[53-64]岁，72%男性）。40例(33%)患者术后出现早期并发症。在LT术后严重早期并发症的患者中，经血红蛋白校正的一氧化碳肺转移能力（DLCOc）的测量值和预测百分比显着降低。通过多变量分析，DLCOc是唯一与严重早期并发症独立相关的变量。DLCOc低于16.3ml。min-1.mmHg-1预测呼吸系统并发症的敏感性为67.5%，特异性为62.9%。低于61.5%的DLCOc%pred具有56.8%的灵敏度和72%的特异性。DLCOc与强迫肺活量(FVC)独立相关，肺气肿,和肌肉质量指数.
结论：DLCOc降低表明LT术后严重早期并发症的风险增加。
