Authors
Belkacem Acidi, Léa Bergon, Eric Savier, Filomena Conti, Claire Goumard, Florence Jeune, Fabiano Perdigao, Géraldine Rousseau, Olivier Scatton, Chetana Lim
Published in
HPB : the official journal of the International Hepato Pancreato Biliary Association. Oct 26, 2026. Epub Oct 26, 2026.
Abstract
We aimed to identify preoperative predictors of SEP and evaluate its influence on perioperative and long-term outcomes after LT.
This retrospective single-center study included 795 consecutive adult LT recipients between 2018 and 2025. Perioperative and long-term outcomes were evaluated in a 1:1 propensity score-matched cohort of patients with and without SEP.
SEP was diagnosed intraoperatively in 24 of 273 patients with pre-transplant ascites (8.8%). Preoperative computed tomography suggested the diagnosis in 39% of cases. Compared with patients without SEP, those with SEP had a distinct pre-transplant phenotype characterized by a greater burden of ascites-related complications despite lower MELD scores. Previous spontaneous bacterial peritonitis (OR 7.24, 95% CI 2.06-25.49; p = 0.002) and pre-transplant renal dysfunction (OR 10.59, 95% CI 2.64-42.59; p = 0.001) were independently associated with SEP. In the matched cohort, SEP was associated with increased transfusion requirements, higher pulmonary and renal postoperative morbidity, and longer hospital stay. Five-year overall and graft survival were comparable between groups, whereas ascites-related event-free survival was significantly reduced in patients with SEP.
SEP identifies liver transplant recipients at increased perioperative risk rather than poorer long-term prognosis. Earlier identification of SEP may also contribute to optimizing recipient selection and donor-recipient matching strategies.
PMID:
42995033
Bibliographic data and abstract were imported from PubMed on 07 Nov 2026.
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