Pulmonary Function Tests and Liver Transplantation

D. Reino¹, P. Martinez², K. Robichaux³, M. Gosselin⁴, S. Mohammed³, J. Buggs¹, A. Kumar⁵

¹Transplant Surgery, Tampa General Hospital, Tampa, FL, ²University of Miami, Miami, FL, ³University of South Florida, Tampa, FL, ⁴University of Tampa, Tampa, FL, ⁵Morsani College of Medicine, University of South Florida, Tampa, FL

Meeting: 2022 American Transplant Congress

Abstract number: 877

Keywords: Liver transplantation, Post-operative complications

Topic: Clinical Science » Liver » 55 - Liver: Recipient Selection

Session Information

Session Name: Liver: Recipient Selection

Session Type: Poster Abstract

Date: Saturday, June 4, 2022

Session Time: 5:30pm-7:00pm

Presentation Time: 5:30pm-7:00pm

Location: Hynes Halls C & D

*Purpose: Liver transplant recipients have a high risk of developing postoperative pulmonary complications. Pulmonary function tests (PFTs) are expensive and often incapable of predicting patients at risk or improving patient outcomes, thus a single-center implemented specific criteria to determine when a PFT is administered for the evaluation of patients for liver transplantation. The protocol recommends a PFT for patients with a history of chronic lung disease, recurrent pneumonia prior to transplant, symptomatic COVID-19 requiring hospitalization, tobacco abuse, alpha-1 antitrypsin positivity, or oxygen dependency.

*Methods: We conducted a retrospective cohort study of consecutive adult patients (age greater than 18 years) who underwent deceased donor liver transplantation from January 1, 2020, to June 30, 2021. We analyzed results from pre-protocol (PRE) and post-protocol (POST) implementation.

*Results: There were a total of 215 patients in the study, 186 PRE and 29 POST protocol implementation. In the PRE group, 168 (90%) patients received PFTs compared to 12 (41%) in the POST group, p<0.001). There was no difference between the PRE and POST groups based on age in years (56 vs 55, p=0.713), male gender (65% vs 662%, p=0.83), White race (80% vs 86%, p=0.15), BMI (34 vs 28, p=0.107), or cold ischemic time in hours (5.7 vs 6, p=0.252). There was no difference in FVC (3.3 vs 3.0, p=0.84), FEV1 (2.6 vs 2.2, p=0.87), FEV1/FVC% (76.9 vs 74.4, p=0.47) and DLCO (16.4 vs 13.8, p=0.11). The postoperative variables were the same for both groups with time to extubation hours (25 vs 31, p=0.26), ICU length of stay days (8 vs 10, p=0.12), and transplant admission length of stay days (14.4 vs 17.4, p=0.36). Lastly, there was no difference between PRE and POST graft survival (p=0.69) or patient survival (p=0.08).

*Conclusions: This study demonstrates the successful implementation of a PFT protocol with a cost savings of roughly $38,000 in just three months with no impact on patient outcomes. Further research is indicated for broad-scale implementation.

To cite this abstract in AMA style:

Reino D, Martinez P, Robichaux K, Gosselin M, Mohammed S, Buggs J, Kumar A. Pulmonary Function Tests and Liver Transplantation [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/pulmonary-function-tests-and-liver-transplantation/. Accessed November 25, 2024.

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