Impact of Liver Transplantation on Carbon Monoxide Production as Measured by Arterial Carboxyhemoglobin Levels in Cirrhotic Patients with and without Hepatopulmonary Syndrome

14 September 2021: Original Paper

Ralph Llewel Sabang ^1ABCDEF* , Mohammad Abu-Hishmeh ^2ABC , Roxana Bodin ^3DEF , Oleg Epelbaum ^4ABCDEF

DOI: 10.12659/AOT.932009

Ann Transplant 2021; 26:e932009

Table 1 Baseline demographic and clinical characteristics of the study patients.

	All patientsN=39	With HPSN=14	Without HPSN=25	p-Value
Age	59±8	61±5	58±9	0.23
Male gender	28 (72%)	8 (57%)	20 (80%)	0.45
ESRD	7 (18%)	1 (7%)	6 (24%)	0.39
Ascites	27 (69%)	10 (71%)	17 (68%)	0.71
Hepatic encephalopathy	15 (38%)	8 (57%)	7 (28%)	0.16
MELD score (listing)	32±5	33±4	32±5	0.35
MELD score (physiologic)	19±10	20±10	19±10	0.87
Serum sodium	136±5	135±6	136±5	0.51
Serum creatinine^*	1.08±0.69	1.26±0.55	1.00±0.78	0.97
Serum bilirubin	6±9	7±7	6±9	0.77
Serum albumin	3.1±0.5	3.0±0.5	3.2±0.5	0.22
INR	1.6±0.6	1.7±0.8	1.5±0.5	0.58
Indications for liver transplantation^**
HCC	19 (49%)	4 (29%)	15 (60%)	0.09
HCV	17 (44%)	6 (43%)	11 (44%)	1
Alcohol	11 (28%)	4 (29%)	7 (28%)	1
NASH	8 (11%)	5 (36%)	3 (12%)	0.11
Others^***	3 (8%)	0	3 (12%)	–
Pre-transplant PaO (mmHg)	84±16	78±17	87±14	0.069
HPS severity^****
Mild		7 (50%)
Moderate		5 (36%)
Severe		1 (7%)
Very Severe		1 (7%)
Days from transplant to post-transplant ABG median (IQR)	151 (91–318)	136 (69–339)	187 (93–317)	0.79
ABG – arterial blood gas; ESRD – end-stage renal disease; HCC – hepatocellular carcinoma; HCV – hepatitis C virus; HPS – hepatopulmonary syndrome; INR – international normalized ratio; MELD – Model for End-Stage Liver Disease score; NASH – non-alcoholic steatohepatitis. ^* Reflects serum creatinine of patients not receiving dialysis; ^ some patients had multiple indications for liver transplantation; ^* others: Alpha 1 antitrypsin deficiency=1, Primary Sclerosing Cholangitis=1, Cryptogenic Cirrhosis=1; ^**** HPS severity: [] Mild – ≥80 mmHg, Moderate –