Dataset Information

The incidence and natural history of ascites after liver transplantation.

ABSTRACT:

Background

Ascites is common in cirrhosis but uncommon after liver transplant. We aimed to characterize the incidence, natural history, and current management strategies of post-transplant ascites.

Methods

We performed a retrospective cohort study of patients who underwent liver transplantation at 2 centers. We included patients who underwent deceased donor whole graft liver transplants between 2002 and 2019. Chart review identified patients with post-transplant ascites, requiring a paracentesis between 1 and 6-month post-transplants. Detailed chart review identified clinical and transplant characteristics, evaluation of ascites etiology, and treatments.

Results

Of 1591 patients who successfully underwent a first-time orthotopic liver transplant for chronic liver disease, 101 (6.3%) developed post-transplant ascites. Only 62% of these patients required large volume paracentesis for ascites before transplant. 36% of patients with post-transplant ascites had early allograft dysfunction. Most patients with post-transplant ascites (73%) required a paracentesis within 2 months of transplant, but 27% had delayed ascites onset. From 2002 to 2019, ascites studies were obtained less often, and hepatic vein pressure measurement was performed more often. Diuretics were the mainstay of treatment (58%). The use of albumin infusion and splenic artery embolization to treat post-transplant ascites increased over time. Larger pre-transplant spleen size was associated with a greater number of post-transplant paracenteses (r=0.32 and p=0.003). For patients who underwent splenic intervention, paracentesis frequency was significantly reduced (1.6-0.4 paracenteses/month, p=0.0001). The majority (72%) of patients had clinical resolution of their ascites at 6-month post-transplant.

Conclusions

Persistent or recurrent ascites continues to be a clinical issue in the modern era of liver transplantation. Most had clinical resolution within 6 months, some requiring intervention.

SUBMITTER: Bloom PP

PROVIDER: S-EPMC10208690 | biostudies-literature | 2023 Jun

REPOSITORIES: biostudies-literature

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Publications

The incidence and natural history of ascites after liver transplantation.

Bloom Patricia P PP Gilbert Timothy T Gilbert Timothy T Santos-Parker Keli K Memel Zoe Z Przybyszewski Eric E Bethea Emily E Sonnenday Christopher J CJ Tapper Elliot B EB Waits Seth S

Hepatology communications 20230523 6

<h4>Background</h4>Ascites is common in cirrhosis but uncommon after liver transplant. We aimed to characterize the incidence, natural history, and current management strategies of post-transplant ascites.<h4>Methods</h4>We performed a retrospective cohort study of patients who underwent liver transplantation at 2 centers. We included patients who underwent deceased donor whole graft liver transplants between 2002 and 2019. Chart review identified patients with post-transplant ascites, requiring ...[more]

PMID: 37219847

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Dataset Information

The incidence and natural history of ascites after liver transplantation.

Background

Methods

Results

Conclusions

Publications

The incidence and natural history of ascites after liver transplantation.

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