In:
Liver International, Wiley, Vol. 32, No. 8 ( 2012-09), p. 1262-1269
Abstract:
Assess the prevalence of peri‐transplant heart failure and its potential relation to post‐transplant morbidity and mortality. Methods A retrospective study was performed on 234 consecutive cirrhotic patients undergoing liver transplantation in a single European center from 1999 to 2007 (mean age 52, 30% women, 36% with alcoholic liver disease, 24% with viral hepatitis, 18% cholestatic liver disease). Left ventricular diastolic dysfunction was defined as E/A ratio ≤ 1. We used the Boston classification for heart failure to assess the prevalence of peri‐transplant heart failure. Patients were followed up for a mean of 4 years post‐transplant (0.5–9 years). Results Eighteen per cent of patients demonstrated diastolic dysfunction pretransplant. During the peri‐transplantation period highly possible heart failure occurred in 27%. In logistic regression analysis, heart failure was independently related to lower mean arterial blood pressure ( OR 0.94, 95% CR 0.91–0.98) and prolonged corrected QT time on ECG ( OR 9.10, 95% CI 3.77–21.93) pretransplant. Peri‐transplant mortality amounted to 5%, and was independently related to heart failure ( OR 15.11, 95% CI 1.76–129.62) and the peri‐transplant need of dialysis ( OR 14.18, 95% CI 1.65–121.89). Heart failure was also associated with longer stay in the intensive care unit and peri‐transplant cardiac events ( P 〈 0.05). Long‐term transplant‐free mortality was independently related to diastolic dysfunction at baseline (Hazard ratio 4.82, 95% CI 1.78–13.06). Conclusion Heart failure occurs in approximately a quarter of patients with cirrhosis following liver transplantation and it is an independent predictor of mortality and morbidity.
Type of Medium:
Online Resource
ISSN:
1478-3223
,
1478-3231
DOI:
10.1111/liv.2012.32.issue-8
DOI:
10.1111/j.1478-3231.2012.02818.x
Language:
English
Publisher:
Wiley
Publication Date:
2012
detail.hit.zdb_id:
2124684-1
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