Photo Credit: Myboxpra

The following is a summary of “Preoperative DLCO predicts severe early complications after liver transplantation,” published in the February 2024 issue of Pulmonology by Li et al.

Liver transplantation (LT) is often complicated by severe early complications, which significantly impact patient morbidity and mortality. This study aimed to investigate whether pre-operative lung function assessments could predict the occurrence of severe early complications within the first month post-LT.

Retrospectively, patients with mild-to-moderate liver disease (Model for End-stage Liver Disease-MELD score ≤30) underwent LT at a single center between October 2015 and May 2020. The primary endpoint was defined as the presence of severe early complications post-LT, characterized by mechanical ventilation duration > 2 days, ICU stay > 7 days, reintubation, or death within one month of LT.

Of the 120 included patients (mean age 59 years, 72% men), 40 (33%) experienced early complications after LT. Notably, patients with severe early complications exhibited significantly lower measured and %predicted hemoglobin-corrected lung transfer capacity for carbon monoxide (DLCOc). Multivariate analysis revealed DLCOc as the sole independent predictor of severe early complications. A DLCOc value under 16.3 ml.min^-1.mmHg^-1 predicted respiratory complications with 67.5% sensitivity and 62.9% specificity, while a DLCOc%pred under 61.5% had 56.8% sensitivity and 72% specificity. DLCOc was also independently associated with forced vital capacity (FVC), pulmonary emphysema, and the muscle mass index.

A reduction in DLCOc is a valuable predictor for identifying patients at increased risk of severe early complications following LT.

 Source: sciencedirect.com/science/article/abs/pii/S2590041224000060