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Master Thesis

Impact des variables fonctionnelles respiratoires chez les patients cirrhotiques candidats à une transplantation hépatique : survie à dix ans de l'inscription sur liste

Abstract : Background. Respiratory comorbidities are common in cirrhotic patients and may influence the decision for liver transplantation (LT). Our objective was to determine their prevalence and prognostic value. Method. NYHA functional class (FC), 6-minute walk distance (6MWD), arterial blood gases, lung function tests, right heart catheterization and heptopulmonary syndrome (HPS) screening were performed in 289 patients listing for LT. The prognostic value of respiratory parameters was analyzed over a period of 10 years. Results. The mean age was 52 ± 8 years (78% males, 72% Child-Pugh (CP) stage B or C). 36% were in NYHA-FC II or more, 47% had hypoxemia and 15% had obstructive ventilatory disorder. The prevalence of hepatic hydrothorax (HH), HPS and portopulmonary hypertension (PoPH) was respectively 6.6%, 12.4% and 1.4%. 6MWD was positively correlated with hemoglobin (p <0.0001), FEV1 (p = 0.006), DLCO (p = 0.03) and negatively with CP stage (p <0.001) and AaD02 ( p = 0.006). Mortality on waiting list was 16.6%. Low FVC and PaO2, diagnosis of PoPH or HH were associated with a higher risk of mortality on list. 214 patients (74%) were transplanted. The overall survival after LT was 86%, 74% and 63% at 1, 5 and 10 years. Respiratory or hemodynamic parameters were not correlated with post-LT mortality. Conclusion. Respiratory comorbidities are frequent in patients listing for LT and associated with an increased risk of mortality on waiting list but without impact on post-transplant mortality.
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https://dumas.ccsd.cnrs.fr/dumas-03180778
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Submitted on : Thursday, March 25, 2021 - 11:41:33 AM
Last modification on : Wednesday, November 3, 2021 - 5:06:30 AM
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  • HAL Id : dumas-03180778, version 1

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Hélène Pringuez. Impact des variables fonctionnelles respiratoires chez les patients cirrhotiques candidats à une transplantation hépatique : survie à dix ans de l'inscription sur liste. Médecine humaine et pathologie. 2020. ⟨dumas-03180778⟩

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