Pleural Effusions Following Liver Transplantation: A Single-Center Experience

Justin K. Lui, Lidia Spaho, Shahrad Hakimian, Michael Devine, Rosa Bui, Sunkaru Touray, Erik Holzwanger, Boskey Patel, Daniel Ellis, Svetlana Fridlyand, Adedotun A. Ogunsua, Paria Mahboub, Jennifer S. Daly, Adel Bozorgzadeh, Scott E. Kopec

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Introduction: This was a single-center retrospective study to evaluate incidence, prognosis, and risk factors in patients with postoperative pleural effusions, a common pulmonary complication following liver transplantation. Methods: A retrospective review was performed on 374 liver transplantation cases through a database within the timeframe of January 1, 2009 through December 31, 2015. Demographics, pulmonary and cardiac function testing, laboratory studies, intraoperative transfusion/infusion volumes, postoperative management, and outcomes were analyzed. Results: In the immediate postoperative period, 189 (50.5%) developed pleural effusions following liver transplantation of which 145 (76.7%) resolved within 3 months. Those who developed pleural effusions demonstrated a lower fibrinogen (149.6 ± 66.3 mg/dL vs 178.4 ± 87.3 mg/dL; P =.009), total protein (5.8 ± 1.0 mg/dL vs 6.1 ± 1.2 mg/dL; P =.04), and hemoglobin (9.8 ± 1.8 mg/dL vs 10.3 ± 1.9 mg/dL; P =.004). There was not a statistically significant difference in 1-year all-cause mortality and in-hospital mortality between liver transplant recipients with and without pleural effusions. Liver transplant recipients who developed pleural effusions had a longer hospital length of stay (16.4 ± 10.9 days vs 14.0 ± 16.5 days; P =.1), but the differences were not statistically significant. However, there was a significant difference in tracheostomy rates (11.6% vs 5.4%; P =.03) in recipients who developed pleural effusions compared to recipients who did not. Conclusions: In summary, pleural effusions are common after liver transplantation and are associated with increased morbidity. Pre- and intraoperative risk factors can offer both predictive and prognostic value for post-transplantation pleural effusions. Further prospective studies will be needed to further evaluate the relevance of these findings to limit instances of postoperative pleural effusions.

Original languageEnglish (US)
Pages (from-to)862-872
Number of pages11
JournalJournal of Intensive Care Medicine
Issue number8
StatePublished - Aug 2021
Externally publishedYes


  • critical care
  • ICU outcomes
  • pulmonary complications

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine


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