Prevalence of postoperative pulmonary complications in recipients of liver transplantation with abnormal preoperative spirometry

Abstract

Objective To determine the incidence of postoperative pulmonary complications in liver transplantation recipients with abnormal preoperative spirometry. Methods A retrospective observational study was conducted among 210 patients with abnormal preoperative spirometry who underwent living donor liver transplantation between April 2012 and January 2024. Liver transplantation recipients were divided into two groups based on the spirometry diagnosis of restrictive lung disease or obstructive lung disease. The incidence of postoperative pulmonary complications and impact on patient outcomes were assessed in terms of length of stay in the intensive care unit, total length of stay in the hospital, time on the ventilator, duration of surgery, noninvasive ventilator dependence, reintubation rate, hospital-acquired infection, mortality, and arterial blood gas analysis. Results The incidence of postoperative pulmonary complications was approximately 91.2% in liver transplantation recipients with abnormal preoperative spirometry. The length of stay in the intensive care unit, total length of stay in the hospital, duration of surgery, noninvasive ventilator dependence, reintubation rate, mortality, and hospital-acquired infections did not notably differ between recipients with restrictive lung disease (n = 189) and obstructive lung disease (n = 21). Discussion Abnormal spirometry resulted in an increased incidence of postoperative pulmonary complications. However, the study suggests that the effects of abnormal spirometry were similar after liver transplantation. Conclusion Preexisting restrictive and obstructive lung diseases are associated with similar risks in liver transplantation recipients. However, as our study had fewer patients with obstructive lung disease, future research should include a comparable number of patients with restrictive and obstructive lung diseases to produce robust data on postoperative complications within this group for liver transplantation.