• Nutchanok Khampitak, Chinnarat Pongpruksa, Drew Cheng, BuiChristine MyoCMDepartment of Anesthesiology and Perioperative Medicine, Ronald Reagan UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, CA., Sophia Poorsattar, Christopher Wray, and Victor W Xia.
• Department of Anesthesiology and Perioperative Medicine, Ronald Reagan UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, CA; Department of Anesthesiology, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
• J. Cardiothorac. Vasc. Anesth. 2024 Sep 4.

ObjectivesTo explore the incidence, risk factors, and impact of elevated mean pulmonary artery pressure (mPAP) on 30-day mortality in liver transplantation (LT).DesignA retrospective study.SettingUniversity tertiary medical center.ParticipantsAdult patients who underwent between 2013 and 2023.InterventionNo intervention.Measurements And Main ResultsData for consecutive adults who underwent LT (n = 1243) between 2013 and 2023 were extracted from our institutional Discovery Data Repository. Elevated mPAP was defined as ≥40 mmHg or a ≥20% increase from baseline during the first hour following reperfusion. The 30-day mortality rate was recorded. Risk factors were identified using multivariable logistic regression. The study cohort had a mean age of 55.2 ± 11.9 years and a mean model for end-stage liver disease sodium (MELD-Na) score of 34.8 ± 6.1. Ninety-one patients (7.3%) developed an elevated postreperfusion mPAP. Multivariable logistic regression revealed that preoperative elevated PAP estimated by echocardiogram, preoperative serum creatinine, and the use of epinephrine during LT were significant risk factors. Thirty-two patients (1.9%) died within 30 days after LT. Elevated postreperfusion mPAP was significantly associated with 30-day mortality (odds ratio, 6.056; 95% confidence interval, 2.349-15.611; p < 0.001).ConclusionsmPAP is frequently elevated after graft reperfusion during LT, but its influence on clinical outcomes remains unclear. This retrospective study found a 7.3% rate of high PAP following reperfusion in LT, and high postreperfusion PAP was associated with 30-day mortality.Copyright © 2024 Elsevier Inc. All rights reserved.

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