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Master Thesis

Complications respiratoires précoces au cours des 10 premiers jours après transplantation hépatique : analyse descriptive

Abstract : The purpose of this study was to describe the incidence, prevalence and risk factors of respiratory complications after liver transplantation (LT) using lung ultrasound as a diagnostic and monitoring tool; and to evaluate the impact of preoperative organ failure. Methods: This single-center prospective study included 201 consecutive patients who underwent LT over a period of 46 months. Lung and heart ultrasounds were performed at day 1, 2, 3, 4, 7 and 10 postoperative. The outcomes were the incidence, prevalence and risk factors for respiratory complications. Results: Diaphragmatic dysfunction was a very frequent complication, early, reversible and lateralized to the right side. The protective factor was the piggyback method (OR 0.37). Pleural effusion was frequent, with a progressive worsening, lateralized to the right side and promoted by preoperative infections (OR 3.1). Atelectasis was more common on the right side and in patients without preoperative organ failure, favored by postreperfusion syndrome (OR 2.6), UW preservation solution (OR 2.8) and prevented by the piggyback method (OR 0.3). Pneumonia was more frequent in case of preoperative organ failure, promoted by immunosuppression (OR 1.4), alcoholic cirrhosis (OR 2.2) and preoperative mechanical ventilation (OR 3.8). Liver transplantation induced lung injury was an original entity induced by inflammatory mechanisms secondary to cirrhosis and LT. Risk factors were the piggyback method (OR 3.2) and restrictive lung pattern (OR 3.1). Hepatocellular carcinoma was a protective factor (OR 0.33). Conclusion: Early respiratory complications after LT are frequent and influenced by preoperative organ failure.
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Master Thesis
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Submitted on : Tuesday, April 25, 2017 - 1:47:30 PM
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  • HAL Id : dumas-01513691, version 1

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Karim Bouattour. Complications respiratoires précoces au cours des 10 premiers jours après transplantation hépatique : analyse descriptive. Médecine humaine et pathologie. 2016. ⟨dumas-01513691⟩

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