Ocena kardiologiczna kandydatów do przeszczepienia wątroby
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Streszczenie
BACKGROUND: Liver transplantation (LT) is at high-risk for cardiovascular events. Therefore, candidates have pre-operative cardiological diagnostics to reduce risk of complications after surgery. The purpose of the study was to analyze a cohort of liver recipients from one transplant centre in Poland and to evaluate the accuracy of pretransplant cardiac assessment in the prediction of short and long-term outcomes and to investigate correlation of cardiovascular events with the patient’s characteristics. MATERIAL AND METHODS: This retrospective study was conducted among 141 consecutive patients evaluated for LT in 2017-1018. Recipients under 40 were excluded. All candidates had ECG, echocardiography and their functional capacity was assessed. Patients with MET < 4 or clinical indications were subjected to stress echocardiography. After transplantation, patients were re-screened for cardiovascular complications by December 2019. RESULTS: In 2017-2018 141 patients were evaluated, 116 patients were finally listed, 4 recipients were disqualificated for cardiological reasons, the remaining 21 were rejected for non-cardiological reasons. There were no early cardiovascular complications in 30-day follow-up. Late cardiovascular complications were observed in 4 transplanted patients. Diabetes increases cardiovascular complications (p=0,001). CONCLUSION: The applied cardiological diagnostics allowed to avoid early cardiovascular events. Very careful post-transplant monitoring is indicated, particularly in diabetes patients, due to the greater risk of long-term complications. Post-transplant immunosuppression and liver function recovery may contribute to this.
Słowa kluczowe: choroba sercowo-naczyniowazdarzenia sercowo-naczyniowetransplantacja wątrobyNODATNATPOL 2011
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