Surgical chest complications after liver transplantation

Abstract

Liver transplantation is a major abdominal operation and the intimate anatomic relation of the liver with the right hemidiaphragm predisposes the patient to various manifestations in the chest cavity. Furthermore, chronic liver disease affects pulmonary function before and after liver transplantation resulting in a considerable percentage of patients presenting with morbidity related to chest complications. This review aims to identify the potential chest complications of surgical interest during or after liver transplantation. Complications of surgical interest are defined as those conditions that necessitate an invasive procedure (such as thoracocentesis or a chest tube placement) in the chest or a surgical intervention performed by a thoracic surgeon. These complications will be classified as perioperative and postoperative; the latter will be categorized as early and late. Although thoracocentesis or a chest tube placement is usually sufficient when invasive measures are deemed necessary, in some patients, thoracic surgical interventions are warranted. A high index of suspicion is needed to recognize and treat these conditions promptly. A close collaboration between abdominal surgeons, intensive care unit physicians and thoracic surgeons is of paramount importance.

Keywords: Surgical chest complications; Liver transplantation; Chest related morbidity; Multidisciplinary treatment; Surgery

Core Tip: Chest complications during and after liver transplantation significantly affects the surgical and hospitalization outcomes. This minireview focuses on surgical chest complications for transplant patients and categorizes them by time of appearance. This paper may be a helpful guide and tool for medical students, members of the transplantation team and all the collaborative specialties to recognize early chest complications and plan the appropriate treatment.