Clinical Report: Prevalence, Severity, and Post-Transplant Mortality of Symptomatic Pleural Effusion in Adult Candidates for Liver Transplantation
Overview
Revise to include specific statistics linking symptomatic pleural effusion to post-transplant mortality.
Background
End-stage liver disease (ESLD) is a significant global health issue, with liver transplantation being the definitive treatment for advanced hepatic failure. Hepatic hydrothorax (HH), a complication of cirrhosis, can severely impact patient outcomes, yet its effects on post-transplant mortality are not well understood. Understanding the implications of symptomatic pleural effusion in liver transplant candidates is crucial for optimizing patient management and transplant prioritization.
Data Highlights
Characteristic
With Pleural Effusion (n=59)
Without Pleural Effusion (n=400)
MELD Score
Higher
Lower
30-day Mortality
Increased
Standard
90-day Mortality
Increased
Standard
Overall Mortality
Higher
Lower
Key Findings
12.8% of liver transplant candidates had symptomatic pleural effusion.
Patients with pleural effusion exhibited higher MELD and Child–Pugh scores.
Symptomatic pleural effusion was associated with increased 30-day and 90-day post-transplant mortality.
Untreated hepatic hydrothorax carries a median survival of only 8–12 months.
Patients with refractory HH who received MELD exceptions had improved post-transplant survival.
Clinical Implications
Clinicians should prioritize liver transplant evaluation for patients with symptomatic pleural effusion, as it indicates more severe liver disease and higher mortality risk. Early intervention and consideration for MELD exception points may improve outcomes for these patients.
Conclusion
The presence of symptomatic pleural effusion in liver transplant candidates is a significant predictor of post-transplant mortality, highlighting the need for careful evaluation and management of these patients.
