The Canadian Hepatopulmonary Syndrome Program: A Longitudinal Liver Transplant Experience
Bibliographic record
Abstract
Background/Aims: Hepatopulmonary syndrome (HPS) is a pulmonary complication of liver disease comprised of liver dysfunction, intrapulmonary vascular dilatations, and abnormal oxygenation. Liver transplantation (LT) is the only curative treatment for HPS, but outcome reports in objectively diagnosed cohorts are mostly from single centers with mild/moderate disease populations and short-term follow-up. Methods: This was a retrospective cohort study in which we sought to describe short- and long-term LT outcomes and their predictors in the Canadian HPS Program. Results: (HR: 0.93 [0.87-0.99]) and higher in those with obstructive lung disease (HR: 6.96 [1.29-37.43]). Oxygenation normalized in 46 of 47 (97.9%) patients 6 months after LT. Infectious (25/53; 47.2%) and biliary (26/53; 49.1%) complications were common. Malignancy occurred in 13 of 49 (26.5%) patients over a median follow-up 5.8 years. Conclusion: We present LT data in the most severe and among the largest and longest-followed HPS cohorts reported to date. Our favorable outcomes compared to smaller centers and large databases suggest that high-volume centers with HPS expertise are preferable for LT in severe/very severe HPS. Heightened vigilance for specific short-term complications along with close monitoring of patients with comorbid obstructive lung disease is indicated. Our detailed analysis of post-transplant events and time course of disease resolution/oxygen cessation can inform patient/family counseling and provider expectations.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".