open access

Vol 15, No 2 (2020)
Original Papers
Published online: 2020-03-28
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Cardiovascular assessment in liver transplant candidates

Marta Pokorska, Marta Wawrzynowicz-Syczewska, Barbara Larysz
DOI: 10.5603/FC.2020.0018
·
Folia Cardiologica 2020;15(2):93-98.

open access

Vol 15, No 2 (2020)
Original Papers
Published online: 2020-03-28

Abstract

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.

Abstract

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.
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Keywords

cardiovascular disease; cardiovascular events; liver transplantation; NODAT; NATPOL 2011

About this article
Title

Cardiovascular assessment in liver transplant candidates

Journal

Folia Cardiologica

Issue

Vol 15, No 2 (2020)

Pages

93-98

Published online

2020-03-28

DOI

10.5603/FC.2020.0018

Bibliographic record

Folia Cardiologica 2020;15(2):93-98.

Keywords

cardiovascular disease
cardiovascular events
liver transplantation
NODAT
NATPOL 2011

Authors

Marta Pokorska
Marta Wawrzynowicz-Syczewska
Barbara Larysz

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