ArticleTransplantation2017
Predictors of Waitlist Mortality in Portopulmonary Hypertension.
Article in Transplantation, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- International Liver Transplantation Society practice guideline update on portopulmonary hypertension.Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society · 2026Guideline
- Asian Pacific Association for the Study of the Liver clinical practice guidelines on liver transplantation.Hepatology international · 2024Guideline
- The Importance of Liver-Lung Communication in Pulmonary Vascular Diseases.Comprehensive Physiology · 2026Review
- Bioinformatics Analysis Identifies a Potential Key Gene in the Pathogenesis of Pulmonary Hypertension-HSPH1.Pulmonary circulation · 2025Article
- Clinical outcomes of upfront combination therapy for portopulmonary hypertension.International journal of cardiology. Cardiovascular risk and prevention · 2024Article
- Association of Cardiopulmonary Hemodynamics and Mortality in Veterans With Liver Cirrhosis: A Retrospective Cohort Study.Journal of the American Heart Association · 2024Article
- The Clinical Course of Portopulmonary Hypertension and Outcomes With Endothelin Receptor Antagonist Treatment: Observational Study of Data From the US Organ Procurement and Transplantation Network.Transplantation direct · 2024Article
- [Pulmonary Complications in Patients with Liver Cirrhosis].The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi · 2023Review
- Unrecognized Pulmonary Hypertension in Non-Cardiac Surgical Patients: At-Risk Populations, Preoperative Evaluation, Intraoperative Management and Postoperative Complications.Journal of cardiovascular development and disease · 2023Review
- Portopulmonary Hypertension: An Updated Review.Transplantation direct · 2023Review
- Temporal Trends in Portopulmonary Hypertension Model for End-stage Liver Disease Exceptions and Outcomes.Transplantation direct · 2022Article
- Clinical Management and Outcomes of Patients With Portopulmonary Hypertension Enrolled in the Japanese Multicenter Registry.Circulation reports · 2022Article
- Portopulmonary hypertension: Current developments and future perspectives.Liver research (Beijing, China) · 2022Review
- Living donor liver transplantation versus donation after brain death and donation after circulatory death liver transplantation in the US.Proceedings (Baylor University. Medical Center) · 2022Article
- Novel Prognostic Models for Predicting the 180-day Outcome for Patients with Hepatitis-B Virus-related Acute-on-chronic Liver Failure.Journal of clinical and translational hepatology · 2021Article
- Causes and Circumstances of Death in Portopulmonary Hypertension.Transplantation direct · 2021Article
- Sex Differences in Portopulmonary Hypertension.Chest · 2021Article
- Outcomes of Liver Transplantation in Treated Portopulmonary Hypertension Patients With a Mean Pulmonary Arterial Pressure ≥35 mm Hg.Transplantation direct · 2020Article
- Macitentan Improves Risk Categorization for Liver Transplant Mortality in Patients With Portopulmonary Hypertension: A PORTICO Study Post Hoc Analysis.Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society · 2020Article
- Hepatopulmonary Syndrome and Portopulmonary Hypertension: The Pulmonary Vascular Enigmas of Liver Disease.Clinical liver disease · 2020Review
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
backgroundThe current Organ Procurement Transplantation Network policy grants Model for End-Stage Liver Disease (MELD) exception points to patients with portopulmonary hypertension (POPH), but potentially important factors, such as severity of liver disease and pulmonary hypertension, are not included in the exception score, and may affect survival. The purpose of this study was to identify significant predictors of waitlist mortality in patients with POPH.
methodsWe performed a retrospective cohort study of patients in the Organ Procurement and Transplantation Network database with hemodynamics consistent with POPH (defined as mean pulmonary arterial pressure >25 mm Hg and pulmonary vascular resistance [PVR] ≥240 dynes·s·cm) who were approved for a POPH MELD exception between 2006 and 2014. Using a Cox proportional hazards model, we identified predictors of waitlist mortality (or removal for clinical deterioration).
resultsOne hundred ninety adults were included. Age (hazard ratio [HR], 1.04; 95% confidence interval [CI], 1.00-1.08; P = 0.0499), initial native MELD score (HR, 1.11; 95% CI, 1.05-1.17; P < 0.001), and initial PVR (HR, 1.12 per 100 dynes·s·cm; 95% CI, 1.02-1.23; P = 0.02) were the only significant univariate predictors of waitlist mortality and remained significant predictors in a multivariate model, which had a c-statistic of 0.71. PVR and mean pulmonary arterial pressure were not significant predictors of posttransplant mortality.
conclusionsBoth the severity of liver disease and POPH (as assessed by MELD and PVR, respectively) were significantly associated with waitlist, but not posttransplant, mortality in patients with approved MELD exceptions for POPH. Both factors should potentially be included in the POPH MELD exception score to more accurately reflect waitlist mortality risk.
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