ENVIRONMENTAL RISK FACTORS FOR PULMONARY COMPLICATIONS AFTER LIVER TRANSPLANTATION

Abstract

Liver transplant is a successful treatment for patients with acute liver failure and end-stage liver cirrhosis, but the procedure carries with it risks for morbidity and mortality. Postoperative pulmonary complications contribute to the morbidity and mortality in liver transplant recipients; however, the risk factors related with these complications have not been completely defined. Pulmonary complications, particularly pleural effusion and atelectasis, have a significant effect on mortality and morbidity of patients following orthotopic liver transplant. In addition, by prolonging the length of stay in the hospital and in the intensive care unit as well as the duration of intubation, higher hospital costs result. Patients at risk of pulmonary complications such as smokers, those with prolonged duration of hospitalization, and positive results on deep tracheal aspirate culture should be followed closely after surgery. Invasive and noninvasive diagnostic methods should be used early; pulmonary function test results and arterial blood gas results should not be the sole preoperative criteria for determining risk for undergoing liver transplant. To decrease pulmonary complications after surgery, liver transplant should be planned before multisystem involvement is seen. This work aims to determine enviromental risk factors associated with pulmonary complications in liver transplant patients and also early detection of pulmonary complications in patients exposed toenviromental risk factors for further intervention.