Approach to persistent ascites after liver transplantation

Znanstveni rad - Pregledni rad

• Autor: Ana Ostojić
• Autor: Igor Petrović
• Autor: Hrvoje Silovski
• Autor: Iva Košuta
• Autor: Maja Sremac
• Autor: Anna Mrzljak
• Autorova ustanova: Sveučilište u Zagrebu; Medicinski fakultet; (KATEDRA ZA INTERNU MEDICINU)
• Znanstveno / umjetničko područje, polje i grana: BIOMEDICINA I ZDRAVSTVO; Kliničke medicinske znanosti; Interna medicina

Sažetak (engleski)

Persistent ascites (PA) after liver transplantation (LT), commonly defined as ascites lasting more than 4 wk after LT, can be expected in up to 7% of patients. Despite being relatively rare, it is associated with worse clinical outcomes, including higher 1-year mortality. The cause of PA can be divided into vascular, hepatic, or extrahepatic. Vascular causes of PA include hepatic outflow and inflow obstructions, which are usually successfully treated. Regarding modifiable hepatic causes, recurrent hepatitis C and acute cellular rejection are the leading ones. Considering predictors for PA, the presence of ascites, refractory ascites, hepato-renal syndrome type 1, spontaneous bacterial peritonitis, hepatic encephalopathy, and prolonged ischemic time significantly influence the development of PA after LT. The initial approach to patients with PA should be to diagnose the treatable cause of PA. The stepwise approach in evaluating PA includes diagnostic paracentesis, ultrasound with Doppler, and an echocardiogram when a cardiac cause is suspected. Finally, a percutaneous or transjugular liver biopsy should be performed in cases where the diagnosis is unclear. PA of unknown cause should be treated with diuretics and paracentesis, while transjugular intrahepatic portosystemic shunt and splenic artery embolization are treatment methods in patients with refractory ascites after LT.

• Ključne riječi (engleski): Acute cellular rejection; Hepatic graft inflow obstructions; Hepatic graft outflow obstructions; Liver transplantation; Liver transplantation complications, Ascites
• Jezik: engleski
• Vrsta publikacije: Znanstveni rad - Pregledni rad
• Status objave: Objavljen
• Vrsta recenzije: Recenziran
• Verzija publikacije: Objavljena verzija rada (izdavačev PDF)
• Naslov časopisa: World Journal of Hepatology
• Brojčani podaci: vol. 14, br. 9, str. 1739-1746
• p-ISSN: 1948-5182
• DOI: https://doi.org/10.4254/wjh.v14.i9.1739
• URN:NBN: urn:nbn:hr:105:408151
• Datum objave publikacije: 2022-09-27
• URL dokumenta: https://www.wjgnet.com/1948-5182/full/v14/i9/1739.htm
• Vrsta resursa: Tekst
• Prava pristupa: Otvoreni pristup
• Datum i vrijeme pohrane: 2023-08-25 08:07:34