Chemical
pleurodesis is one of the therapeutic tools to control hepatic
hydrothorax.
Tetracycline and derivatives have been widely accepted as an effective and safe treatment for the purpose, but availability is the big concern.
Tigecycline is an
antibiotic derivative of
tetracycline, which has demonstrated to be an effective pleurodesing agent in animal models. The aim of the study was to document two successful
tigecycline pleurodesis in patients with decompensated
liver cirrhosis, who were not candidates for
liver transplantation. Both patients were undergoing
palliative treatment for
cirrhosis and developed massive
pleural effusion on the right side. They underwent chemical
pleurodesis in the first instance. Diagnostic thoracocentesis was done to rule out differentials and to confirm the clinical suspicion, following which, complete drainage of pleural fluids was achieved.
Tigecycline of 3 mg/kg was instilled intrapleurally via the thoracic
catheter, as per the protocol. The medical records and images were thoroughly reviewed. There was no recurrence of the effusion for at least 3 months, with no detected complications in the short- or long-term follow-up. In conclusion,
pleurodesis with
tigecycline seems to be effective and safe for the management of symptomatic hepatic
hydrothorax and should therefore be promoted in the setting of
liver cirrhosis at least for a short-term relief, especially in patients who do not meet the criteria for
liver transplantation.