Pre-transplant renal impairment predicts posttransplant cardiac events in patients with liver cirrhosis.
Cast your vote
You can rate an item by clicking the amount of stars they wish to award to this item.
When enough users have cast their vote on this item, the average rating will also be shown.
Your vote was cast
Thank you for your feedback
Thank you for your feedback
MetadataShow full item record
CitationTransplantation 2014, 98 (1):107-14
AbstractCardiovascular disease and renal impairment are common in cirrhotic transplant candidates. We aimed to investigate potential association between pretransplant renal function impairment and cardiac events after liver transplantation.
Adult cirrhotic patients undergoing first-time liver transplantation between 1999 and 2007 in a single institution with available glomerular filtration rate (GFR), assessed by Cr-EDTA clearance at pre-transplant evaluation, were retrospectively enrolled (n=202). Impaired renal function was defined as GFR less than 60 mL/min/1.73 sqm. Pretransplant QT-time corrected by heart rate (QTc) and left-ventricular dysfunction was also registered. Mortality and cardiac events were analyzed, until death or last follow-up (end 2009).
Renal impairment was present in 24% (48/202). Cardiac events occurred in 28% (56/202) after transplantation, mean follow-up time of 3.8 years (2.2). Events were more common in patients with renal impairment compared with those without (48% versus 21%, P<0.001). In Cox regression analysis, pretransplant renal impairment was found to be an independent predictor of posttransplant cardiac events (HR 2.19, 95% CI 1.25-3.85) and reduced cardiac event-free survival (HR 2.27, 95% CI 1.31-3.94). Prolonged QTc interval was an independent predictor of posttransplant cardiac events in the subgroup with pretransplant electrocardiogram and echocardiogram (n=166 and n=112, HR 4.75, 95% CI 2.07-10.9); however, left-ventricular diastolic dysfunction was not (P>0.05). A pretransplant score comprising renal impairment, prolonged QTc interval, and age older than 52 was developed for prediction of 3- and 12-month cardiac events (c-statistic 0.73 and 0.75, respectively).
Pretransplant renal impairment is a predictor of cardiac event after liver transplantation together with prolonged QTc interval.
DescriptionTo access publisher's full text version of this article click on the hyperlink at the bottom of the page
RightsArchived with thanks to Transplantation
- Impact of peri-transplant heart failure & left-ventricular diastolic dysfunction on outcomes following liver transplantation.
- Authors: Josefsson A, Fu M, Allayhari P, Björnsson E, Castedal M, Olausson M, Kalaitzakis E
- Issue date: 2012 Sep
- Inaccuracies of creatinine and creatinine-based equations in candidates for liver transplantation with low creatinine: impact on the model for end-stage liver disease score.
- Authors: Francoz C, Prié D, Abdelrazek W, Moreau R, Mandot A, Belghiti J, Valla D, Durand F
- Issue date: 2010 Oct
- Outcomes of patients with cirrhosis and hepatorenal syndrome type 1 treated with liver transplantation.
- Authors: Wong F, Leung W, Al Beshir M, Marquez M, Renner EL
- Issue date: 2015 Mar
- Reversible non-ischaemic cardiomyopathy and left ventricular dysfunction after liver transplantation: a single-centre experience.
- Authors: Yataco ML, Difato T, Bargehr J, Rosser BG, Patel T, Trejo-Gutierrez JF, Pungpapong S, Taner CB, Aranda-Michel J
- Issue date: 2014 Jul
- Outcomes after heart transplantation in patients with and without pretransplant renal dysfunction.
- Authors: Molina EJ, Sandusky MF, Gupta D, Gaughan JP, McClurken JB, Furukawa S, Macha M
- Issue date: 2010 Jun