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Vol 9, No 1 (2024)
Research paper
Published online: 2023-08-01
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Systematic review and meta-analysis of the co-occurrence of atrial fibrillation and liver transplantation: a lethal combination

Francesco Chirico1, Lukasz Szarpak23, Michal Pruc45, Joanna Rusecka6, Iwona Jannasz7, Tomasz Targowski7, Nicola L. Bragazzi8, Krzysztof Jankowski910, Zubaid Rafique2, Frank William Peacock2
DOI: 10.5603/DEMJ.a2023.0029
·
Disaster Emerg Med J 2024;9(1):16-22.
Affiliations
  1. Post-Graduate School of Occupational Health, Universita Cattolica del Sacro Cuore, Rome, Italy
  2. Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX, USA
  3. Research Unit, Maria Sklodowska-Curie Bialystok Oncology Center, Bialystok, Poland
  4. Research Unit, Polish Society of Disaster Medicine, Warsaw, Poland
  5. Department of Public Health, International Academy of Ecology and Medicine, Kyiv, Ukraine
  6. Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy, Warsaw, Poland
  7. Department of Geriatrics, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
  8. Laboratory for Industrial and Applied Mathematics (LIAM), York University, Canada
  9. Department of Social Medicine and Public Health, Medical University of Warsaw, Poland
  10. National Geriatrics, Rheumatology and Rehabilitation Institute, Warsaw, Poland

open access

Vol 9, No 1 (2024)
ORIGINAL ARTICLES
Published online: 2023-08-01

Abstract

INTRODUCTION: This systematic review and meta-analysis is aimed to evaluate the role of new-onset atrial fibrillation (NOAF) in patients after liver transplantation (LT) and determine the effect of NOAF on the incidence of mortality and graft rejection.

MATERIAL AND METHODS: Published studies until the end of April 15, 2023, were systematically searched in PubMed, Google Scholar, Scopus, Embase, Web of Science, and the Cochrane databases. Odds ratios (ORs) with 95% confidence intervals (CI) for mortality and graft rejection were extracted.

RESULTS: Five studies with a total of 4788 unique post-LT patients were included in the meta-analysis. Pooled analysis showed that mortality in patients with and without NOAF varied and amounted to 24.1% vs. 12.5%, respectively (OR = 2.51; 95%CI: 1.92 to 3.27; p < 0.001). Moreover, pooled analysis showed that graft rejection in the NOAF cohort was 26.3%, and was higher vs. patients without NOAF (13.1%; OR = 2.98; 95%CI: 2.14 to 4.15; p < 0.001)

CONCLUSIONS: Post-LT NOAF is associated with increased mortality and a higher risk of graft rejection. It is likely that the development of a standard procedure for early identification of NOAF, as well as to develop recommendations for specific treatment targeted at avoiding the impacts of the illness, could provide a mortality reduction and provide an increased rate of successful LT.

Abstract

INTRODUCTION: This systematic review and meta-analysis is aimed to evaluate the role of new-onset atrial fibrillation (NOAF) in patients after liver transplantation (LT) and determine the effect of NOAF on the incidence of mortality and graft rejection.

MATERIAL AND METHODS: Published studies until the end of April 15, 2023, were systematically searched in PubMed, Google Scholar, Scopus, Embase, Web of Science, and the Cochrane databases. Odds ratios (ORs) with 95% confidence intervals (CI) for mortality and graft rejection were extracted.

RESULTS: Five studies with a total of 4788 unique post-LT patients were included in the meta-analysis. Pooled analysis showed that mortality in patients with and without NOAF varied and amounted to 24.1% vs. 12.5%, respectively (OR = 2.51; 95%CI: 1.92 to 3.27; p < 0.001). Moreover, pooled analysis showed that graft rejection in the NOAF cohort was 26.3%, and was higher vs. patients without NOAF (13.1%; OR = 2.98; 95%CI: 2.14 to 4.15; p < 0.001)

CONCLUSIONS: Post-LT NOAF is associated with increased mortality and a higher risk of graft rejection. It is likely that the development of a standard procedure for early identification of NOAF, as well as to develop recommendations for specific treatment targeted at avoiding the impacts of the illness, could provide a mortality reduction and provide an increased rate of successful LT.

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Keywords

atrial fibrillation; risk assessment; mortality; graft rejection; liver transplant

About this article
Title

Systematic review and meta-analysis of the co-occurrence of atrial fibrillation and liver transplantation: a lethal combination

Journal

Disaster and Emergency Medicine Journal

Issue

Vol 9, No 1 (2024)

Article type

Research paper

Pages

16-22

Published online

2023-08-01

Page views

327

Article views/downloads

169

DOI

10.5603/DEMJ.a2023.0029

Bibliographic record

Disaster Emerg Med J 2024;9(1):16-22.

Keywords

atrial fibrillation
risk assessment
mortality
graft rejection
liver transplant

Authors

Francesco Chirico
Lukasz Szarpak
Michal Pruc
Joanna Rusecka
Iwona Jannasz
Tomasz Targowski
Nicola L. Bragazzi
Krzysztof Jankowski
Zubaid Rafique
Frank William Peacock

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