ArticleDiagnostic and interventional radiology (Ankara, Turkey)2026
The relationship between preoperative pulmonary hypertension risk in liver transplant and vascular and biliary complications in the postoperative period.
Article in Diagnostic and interventional radiology (Ankara, Turkey), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeLiver transplantation (LT) is the gold standard definitive treatment for end-stage liver disease (ESLD). In patients with ESLD, preoperative pulmonary hypertension (PHT) secondary to the primary liver pathology is a common complication that causes high mortality and morbidity. This study aimed to determine whether thrombosis, hemorrhage, stenosis, occlusion, and biliary system complications may be indirectly affected by this vascular complication.
methodsThis study retrospectively screened patients undergoing LT at our hospital between 2017 and 2024. A total of 265 patients were included. Preoperative PHT was assessed using transthoracic echocardiography-derived systolic pulmonary arterial pressure measurements, whereas post-transplant computed tomography scans were reviewed for vascular and biliary complications.
resultsThe portal vein complications in the PHT group (17.5%) were higher than those in the non-PHT group (9.4%). In the multivariate logistic regression analysis examining the relationship between PHT level and complications, a significant association with portal vein complications was found. No difference was found between the two groups regarding hepatic vein complications (
conclusionModerate-to-severe PHT levels were found to be associated with a significantly increased risk of portal vein complications. We believe caution is warranted, as the presence of preoperative PHT can significantly increase the risk of post-LT complications. CLINICAL SIGNIFICANCE: Changes in mediator balance in PHT lead to systemic vascular remodeling and, consequently, systemic vasoconstriction. We believe that this condition may negatively affect graft vascularity in patients undergoing LT, thereby increasing vascular and biliary complications. This study found that PHT is associated with the risk of portal vein complications.
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