Indwelling pleural catheters in hepatic hydrothorax: A single-center series of outcomes and complications.

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Indwelling pleural catheters in hepatic hydrothorax: A single-center series of outcomes and complications.

Chest. 2018 Jul 07;:

Authors: Kniese C, Diab K, Ghabril M, Bosslet G

Abstract
BACKGROUND: Treatment of hepatic hydrothorax (HH) generally involves sodium restriction, diuretics, and serial thoracentesis. In more advanced cases, transjugular intrahepatic portosystemic shunt (TIPS) and liver transplantation may be required. In the past, indwelling tube drainage has been avoided due to concerns about high complication rates and overall poor outcomes. Recently, indwelling pleural catheters (IPCs) have been proposed as a novel treatment option for HH.
METHODS: We retrospectively reviewed patients who had undergone IPC placement for HH over a 10-year period at a large liver transplant referral center. We tracked outcomes, including complication rates and liver transplantation, as well as biomarkers of nutritional status.
RESULTS: Sixty-two patients underwent IPC placement between 2007 and 2017, with 33 (53%) of IPCs placed as a bridge to liver transplant. Complications were seen in 22 (36%) of patients, with empyema being the most common in 10 (16.1%). 10 patients evaluated for liver transplant were successfully transplanted after IPC placement. There were statistically significant decreases in both body mass index and serum albumin levels after IPC placement.
CONCLUSIONS: IPCs represent a potential treatment for refractory hepatic hydrothorax and should be used with caution in patients eligible for liver transplantation. Ideally, IPC use for these patients would be evaluated by a multidisciplinary team. IPC use may lead to small decreases in BMI and serum albumin levels in patients over time.

PMID: 29990479 [PubMed - as supplied by publisher]

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