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Impact of peri-tran...
Impact of peri-transplant heart failure & left-ventricular diastolic dysfunction on outcomes following liver transplantation
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- Josefsson, Axel, 1984 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin,Institute of Medicine
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- Fu, Michael, 1963 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin,Institute of Medicine
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Allayhari, Pari (author)
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Björnsson, Einar, 1958 (author)
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Castedal, Maria, 1964 (author)
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Olausson, Michael, 1956 (author)
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- Kalaitzakis, Evangelos (author)
- Gothenburg University,Göteborgs universitet,Lund University,Lunds universitet,Medicin, Lund,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Medicine, Lund,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Institutionen för medicin,Institute of Medicine
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(creator_code:org_t)
- 2012-05-24
- 2012
- English.
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In: Liver International. - : Wiley. - 1478-3231 .- 1478-3223. ; 32:8, s. 1262-1269
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Abstract
Subject headings
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- Background & Aims: 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.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Annan klinisk medicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Other Clinical Medicine (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Keyword
- cirrhosis
- cirrhotic cardiomyopathy
- heart failure
- left ventricular
- diastolic dysfunction
- liver transplantation
- survival
- cirrhosis; cirrhotic cardiomyopathy; heart failure; left ventricular diastolic dysfunction; liver transplantation; survival
Publication and Content Type
- art (subject category)
- ref (subject category)
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- By the author/editor
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Josefsson, Axel, ...
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Fu, Michael, 196 ...
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Allayhari, Pari
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Björnsson, Einar ...
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Castedal, Maria, ...
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Olausson, Michae ...
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show more...
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Kalaitzakis, Eva ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Other Clinical M ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Surgery
- Articles in the publication
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Liver Internatio ...
- By the university
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Lund University
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University of Gothenburg