Logo Annals of Transplantation Logo Annals of Transplantation Logo Annals of Transplantation

24 July 2013

Persistent ascites after liver transplantation: Etiology, treatment and impact on survival

Daniel Nils GotthardtABCDEF, Karl Heinz WeissACDEF, Verena Rathenberg, Peter SchemmerADE, Wolfgang StremmelADE, Peter SauerACDE

DOI: 10.12659/AOT.883982

Ann Transplant 2013; 18:378-383

Abstract

Background
Persistent ascites is an uncommon complication after orthotopic liver transplantation (OLT). Data on etiology, treatment and outcome are limited.
Material and Methods
Data on 691 orthotopic liver transplantations in 585 patients were reviewed retrospectively. Patients with persistent ascites (longer than 4 weeks after successful liver transplantation) were selected and for each case two controls (no ascites after 4 weeks) were assigned and matched for age, sex, etiology of liver disease and pre-transplantation Child-Pugh-score/MELD-score.
Results
Persistent ascites for more than 4 weeks after liver transplantation was present in 5.6% (33/585) patients and 4.8% (33/691) cases for a mean of 159±174 days. The most common underlying reason was bacterial or fungal peritonitis (69.7%; 23/33). Other etiologies included renal dysfunction (6%; 2/33), obstruction of the portal vein (3%; 1/33), and obstruction of the liver vein outflow (12%; 4/33); the etiology was unclear in 9% (3/33).
Liver function tests, c-reactive protein levels and parameters of renal function at 4 weeks post liver transplantation did not differ significantly between cases and controls. Patients with persistent ascites had refractory ascites before OLT significantly more often than controls. The 1-year survival rate was 92.3% for controls vs. 75.8% for cases (Kaplan Meier estimate p<0.05).
Treatment (paracentesis; diuretic medical treatment; antibiotic treatment for patients with peritonitis or bacterial infection; radiologic intervention in cases of underlying vascular obstruction) resolved ascites in 72.7% (24/33 patients). Ascites due to infection was treated successfully significantly more often than all other groups (p<0.05).
Conclusions
Persistent ascites after liver transplantation is rare, but is associated with reduced 1-year survival. The underlying mechanisms are diverse, abdominal bacterial infection being the most common cause. The majority of cases can be successfully treated.

Keywords: liver transplantation, ascites, complications after liver transplantation

0 Comments

In Press

17 Jan 2022 : Original article  

Impact of Thyroid Incidentaloma on Liver Transplant: A Study of 1010 Recipients at a Single Center

Ann Transplant In Press; DOI: 10.12659/AOT.934988  

11 Jan 2022 : Original article  

Efficacy of Nitric Oxide-Releasing Nanofibers in Reducing Renal Ischemia-Reperfusion Injury in a Rat Model

Ann Transplant In Press; DOI: 10.12659/AOT.934800  

11 Jan 2022 : Original article  

Effects of Substance P for Liver Regeneration in Rat Hepatectomy Models: A Preliminary Experimental Animal ...

Ann Transplant In Press; DOI: 10.12659/AOT.934801  

Most Viewed Current Articles

29 Dec 2021 : Original article  

Efficacy and Safety of Tacrolimus-Based Maintenance Regimens in De Novo Kidney Transplant Recipients: A Sys...

DOI :10.12659/AOT.933588

Ann Transplant 2021; 26:e933588

22 Dec 2021 : Original article  

Comparison of Coronary Artery Calcium Scoring with Dobutamine Stress Echo for Detection of Coronary Artery ...

DOI :10.12659/AOT.934163

Ann Transplant 2021; 26:e934163

01 Dec 2021 : Original article  

Solid-Phase C1q/C3d Fixing Readouts Correlate with High Median Fluorescence Intensity (MFI) De Novo Donor-S...

DOI :10.12659/AOT.934175

Ann Transplant 2021; 26:e934175

12 Jan 2022 : Original article  

Risk Factors for Developing BK Virus-Associated Nephropathy: A Single-Center Retrospective Cohort Study of ...

DOI :10.12659/AOT.934738

Ann Transplant 2022; 27:e934738

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358