Impact of peri-transplant heart failure & left-ventricular diastolic dysfunction on outcomes following liver transplantation
(2012) In Liver International 32(8). p.1262-1269- Abstract
- 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... (More)
- 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. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/3191336
- author
- Josefsson, Axel ; Fu, Michael ; Allayhari, Pari ; Bjornsson, Einar ; Castedal, Maria ; Olausson, Michael and Kalaitzakis, Evangelos LU
- organization
- publishing date
- 2012
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- cirrhosis, cirrhotic cardiomyopathy, heart failure, left ventricular, diastolic dysfunction, liver transplantation, survival
- in
- Liver International
- volume
- 32
- issue
- 8
- pages
- 1262 - 1269
- publisher
- Wiley-Blackwell
- external identifiers
-
- wos:000307722000010
- scopus:84865182195
- pmid:22621679
- ISSN
- 1478-3231
- DOI
- 10.1111/j.1478-3231.2012.02818.x
- language
- English
- LU publication?
- yes
- id
- 97253c3c-67f7-46fe-b7c7-0a9558f6d46e (old id 3191336)
- date added to LUP
- 2016-04-01 13:36:51
- date last changed
- 2024-01-09 15:59:18
@article{97253c3c-67f7-46fe-b7c7-0a9558f6d46e,
abstract = {{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.}},
author = {{Josefsson, Axel and Fu, Michael and Allayhari, Pari and Bjornsson, Einar and Castedal, Maria and Olausson, Michael and Kalaitzakis, Evangelos}},
issn = {{1478-3231}},
keywords = {{cirrhosis; cirrhotic cardiomyopathy; heart failure; left ventricular; diastolic dysfunction; liver transplantation; survival}},
language = {{eng}},
number = {{8}},
pages = {{1262--1269}},
publisher = {{Wiley-Blackwell}},
series = {{Liver International}},
title = {{Impact of peri-transplant heart failure & left-ventricular diastolic dysfunction on outcomes following liver transplantation}},
url = {{http://dx.doi.org/10.1111/j.1478-3231.2012.02818.x}},
doi = {{10.1111/j.1478-3231.2012.02818.x}},
volume = {{32}},
year = {{2012}},
}