Reviewer ’s report  
 
Title:  A subclinical high tricuspid regurgitation pressure gradient independent of the mean 
pulmonary artery pressure is a risk factor for the survival afte r living donor liver transplantation  
 
Version: 1 Date: 27 Dec 2017 
 
Reviewer:  Georg  Gyoeri  
 
Reviewer’s report:  
 
The authors are to be congratulated for their manuscript on the influency of pulmonary 
hypertension and/or h epatopulmonary syndrome in the context of LDLT as data on this topic is 
limited.  
 
 
Major remarks:  
 
The study is a retrospective review on a heterogenous cohort of 84 patients undergoing LDLT.  
 
Data for assessment of Pulmaory hypertension through TTE is only available from 76 patients.  
 
Pulmonary hypertension was not regularly assessed by Swan Ganz catheterization in a 
pretransplant setting.  
 
Patients were found to have "subclinical" pulmonary hyp ertension or hepatopulmonary 
syndrome or a combination thereof.  
 
Interestingly Swan Ganz catheterization - as in the guidelines - does not correlate with TTE in 
this manuscript.  
 
On longterm outcomes donor age has a significant impact and when looking at c auses of death 
50% of deaths in the high -TRPG group is accounted for HCV recurrence and infection - entities 
clearly unrelated to pulmonary hypertension. Only one patient died of small for size - what was 
the Graft to recipient ratio.  
 
In conclusion the da ta shown do not support the conclusions made.  
 
 
Minor:  
 
The manuscript should be reviewed by a native speaker.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include t he necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
Are you able to  assess any statistics in the manuscript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in  the past five years received reimbursements, fees, funding, or salary from an 
organisation that may in any way gain or lose financially from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisat ion that may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please give details below.  
I declare to have no competing interests with this manuscript  
 
I agree to the open peer review policy of the journal. I understand that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication, my named report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I ag ree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be inc luded in my named report can be included as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
 
Title:  A subclinical high tricuspid regurgitation pressure gradient independent of the mean 
pulmonary artery pressure is a risk factor for the survival afte r living donor liver transplantation  
 
Version: 1 Date: 27 Dec 2017 
 
Reviewer:  Georg  Gyoeri  
 
Reviewer’s report:  
 
The authors are to be congratulated for their manuscript on the influency of pulmonary 
hypertension and/or h epatopulmonary syndrome in the context of LDLT as data on this topic is 
limited.  
 
 
Major remarks:  
 
The study is a retrospective review on a heterogenous cohort of 84 patients undergoing LDLT.  
 
Data for assessment of Pulmaory hypertension through TTE is only available from 76 patients.  
 
Pulmonary hypertension was not regularly assessed by Swan Ganz catheterization in a 
pretransplant setting.  
 
Patients were found to have "subclinical" pulmonary hyp ertension or hepatopulmonary 
syndrome or a combination thereof.  
 
Interestingly Swan Ganz catheterization - as in the guidelines - does not correlate with TTE in 
this manuscript.  
 
On longterm outcomes donor age has a significant impact and when looking at c auses of death 
50% of deaths in the high -TRPG group is accounted for HCV recurrence and infection - entities 
clearly unrelated to pulmonary hypertension. Only one patient died of small for size - what was 
the Graft to recipient ratio.  
 
In conclusion the da ta shown do not support the conclusions made.  
 
 
Minor:  
 
The manuscript should be reviewed by a native speaker.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include t he necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
Are you able to  assess any statistics in the manuscript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in  the past five years received reimbursements, fees, funding, or salary from an 
organisation that may in any way gain or lose financially from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisat ion that may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please give details below.  
I declare to have no competing interests with this manuscript  
 
I agree to the open peer review policy of the journal. I understand that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication, my named report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I ag ree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be inc luded in my named report can be included as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Please review this paper.
user
Reviewer ’s report  
 
Title:  A subclinical high tricuspid regurgitation pressure gradient independent of the mean 
pulmonary artery pressure is a risk factor for the survival afte r living donor liver transplantation  
 
Version: 1 Date: 27 Dec 2017 
 
Reviewer:  Georg  Gyoeri  
 
Reviewer’s report:  
 
The authors are to be congratulated for their manuscript on the influency of pulmonary 
hypertension and/or h epatopulmonary syndrome in the context of LDLT as data on this topic is 
limited.  
 
 
Major remarks:  
 
The study is a retrospective review on a heterogenous cohort of 84 patients undergoing LDLT.  
 
Data for assessment of Pulmaory hypertension through TTE is only available from 76 patients.  
 
Pulmonary hypertension was not regularly assessed by Swan Ganz catheterization in a 
pretransplant setting.  
 
Patients were found to have "subclinical" pulmonary hyp ertension or hepatopulmonary 
syndrome or a combination thereof.  
 
Interestingly Swan Ganz catheterization - as in the guidelines - does not correlate with TTE in 
this manuscript.  
 
On longterm outcomes donor age has a significant impact and when looking at c auses of death 
50% of deaths in the high -TRPG group is accounted for HCV recurrence and infection - entities 
clearly unrelated to pulmonary hypertension. Only one patient died of small for size - what was 
the Graft to recipient ratio.  
 
In conclusion the da ta shown do not support the conclusions made.  
 
 
Minor:  
 
The manuscript should be reviewed by a native speaker.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include t he necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
Are you able to  assess any statistics in the manuscript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in  the past five years received reimbursements, fees, funding, or salary from an 
organisation that may in any way gain or lose financially from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisat ion that may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please give details below.  
I declare to have no competing interests with this manuscript  
 
I agree to the open peer review policy of the journal. I understand that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication, my named report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I ag ree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be inc luded in my named report can be included as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant