Abstract:
Background. The aim of this study was to identify the risk factors related to mortality in
liver transplant (LT) patients with post-transplantation pulmonary complications.
Method. Patients who underwent liver transplantation in our clinic between January 2010 and
January 2012 were retrospectively reviewed for post-transplantation pulmonary complications.
Demographic, clinical, radiologic, and postoperative chart data of 153 patients with pulmonary
complications were analyzed using an independent samples Student t test, Pearson’s c2 test,
Fisher’s exact test, and Yate’s corrected c2 test. Mortality was analyzed using a multiple
logistic regression model. The best-fit breakpoint resulting in a cut-off value for the variables
of interest was determined using ROC curves and the Youden index.
Results. The 153 patients with pulmonary complication were divided into 2 groups: mortality
(n ¼ 53) and survival (n ¼ 100). Univariate analyses showed significant differences between
these 2 groups with respect to MELD score (P ¼ .035), duration of mechanical ventilation (P >
.001), pneumonia (P ¼ .01), and endotracheal culture results (P ¼ .001). In the multivariate
analysis, hemoglobin (P ¼ .03, odds ratio [OR]: 1.239), MELD score (P ¼ .027, OR: 1.064),
duration of mechanical ventilation (P ¼ .003, OR: 1.091), and age (P ¼ .042, OR: 1.001) were
significant risk factors for mortality. The best-fit breakpoint analysis yielded cut-off values for
hemoglobin (>11.2, sensitivity: 50.9%, specificity: 70%), MELD score (>16, sensitivity:
73.6%, specificity: 42%) and duration of mechanical ventilation (>3, sensitivity: 62.3%,
specificity: 76%).
Conclusion. Advanced age, high hemoglobin level, high MELD score, and long-term
mechanical ventilation are significant risk factors for mortality in liver transplant patients
with postoperative pulmonary complications.