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dc.contributor.authorJosefsson, Axel
dc.contributor.authorFu, Michael
dc.contributor.authorBjörnsson, Einar
dc.contributor.authorCastedal, Maria
dc.contributor.authorKalaitzakis, Evangelos
dc.date.accessioned2014-09-04T13:03:04Z
dc.date.available2014-09-04T13:03:04Z
dc.date.issued2014-07-15
dc.date.submitted2014
dc.identifier.citationTransplantation 2014, 98 (1):107-14en
dc.identifier.issn1534-6080
dc.identifier.pmid24621533
dc.identifier.doi10.1097/01.TP.0000442781.31885.a2
dc.identifier.urihttp://hdl.handle.net/2336/325856
dc.descriptionTo access publisher's full text version of this article click on the hyperlink at the bottom of the pageen
dc.description.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.
dc.description.abstractAdult 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).
dc.description.abstractRenal 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).
dc.description.abstractPretransplant renal impairment is a predictor of cardiac event after liver transplantation together with prolonged QTc interval.
dc.description.sponsorshipMedical research council of Vastra Gotaland in Sweden/ALF-22101en
dc.language.isoenen
dc.publisherLippincott Williams & Wilkinsen
dc.relation.urlhttp://dx.doi.org/10.1097/01.TP.0000442781.31885.a2en
dc.relation.urlhttp://ovidsp.uk.ovid.com/sp-3.13.0b/ovidweb.cgi?WebLinkFrameset=1&S=HDHDPDPJBEHFHPMIFNLKPCDGNMAMAA00&returnUrl=ovidweb.cgi%3f%26Full%2bText%3dL%257cS.sh.22.23%257c0%257c00007890-201407150-00016%26S%3dHDHDPDPJBEHFHPMIFNLKPCDGNMAMAA00&directlink=http%3a%2f%2fgraphics.uk.ovid.com%2fovftpdfs%2fPDHFFNDGPCMIBE00%2ffs046%2fovft%2flive%2fgv023%2f00007890%2f00007890-201407150-00016.pdf&filename=Pre-Transplant+Renal+Impairment+Predicts+Posttransplant+Cardiac+Events+in+Patients+With+Liver+Cirrhosis.&pdf_key=PDHFFNDGPCMIBE00&pdf_index=/fs046/ovft/live/gv023/00007890/00007890-201407150-00016en
dc.rightsArchived with thanks to Transplantationen
dc.subjectNýrnasjúkdómaren
dc.subjectLifrarsjúkdómaren
dc.subjectNýruen
dc.subjectSkorpulifuren
dc.subjectÁhættuþættiren
dc.subjectHjartasjúkdómaren
dc.subjectHjartsláttartruflaniren
dc.subjectHjartabilunen
dc.subjectLíffæraflutningaren
dc.subjectLifuren
dc.subject.meshAdulten
dc.subject.meshAgeden
dc.subject.meshArrhythmias, Cardiac/complicationsen
dc.subject.meshDisease-Free Survivalen
dc.subject.meshFemaleen
dc.subject.meshGlomerular Filtration Rateen
dc.subject.meshHeart Diseases/diagnosisen
dc.subject.meshHeart Rateen
dc.subject.meshHumansen
dc.subject.meshKidney/physiopathologyen
dc.subject.meshKidney Diseases/complications*en
dc.subject.meshLiver Cirrhosis/complicationsen
dc.subject.meshLiver Transplantation/adverse effects*en
dc.subject.meshMaleen
dc.subject.meshMiddle Ageden
dc.subject.meshRetrospective Studiesen
dc.subject.meshRisk Factorsen
dc.subject.meshSwedenen
dc.subject.meshTime Factorsen
dc.subject.meshTreatment Outcomeen
dc.subject.meshVentricular Dysfunction, Left/complicationsen
dc.subject.meshVentricular Function, Leften
dc.subject.meshYoung Adulten
dc.subject.meshArrhythmias, Cardiac/diagnosisen
dc.subject.meshArrhythmias, Cardiac/physiopathologyen
dc.subject.meshHeart Diseases/etiology*en
dc.subject.meshHeart Diseases/mortalityen
dc.subject.meshKidney Diseases/diagnosisen
dc.subject.meshKidney Diseases/mortalityen
dc.subject.meshKidney Diseases/physiopathologyen
dc.subject.meshLiver Cirrhosis/diagnosisen
dc.subject.meshLiver Cirrhosis/mortalityen
dc.subject.meshLiver Cirrhosis/surgery*en
dc.subject.meshLiver Transplantation/mortalityen
dc.subject.meshVentricular Dysfunction, Left/diagnosisen
dc.subject.meshVentricular Dysfunction, Left/physiopathologyen
dc.titlePre-transplant renal impairment predicts posttransplant cardiac events in patients with liver cirrhosis.en
dc.typeArticleen
dc.contributor.departmentUniv Gothenburg, Sahlgrenska Acad, Inst Internal Med, S-41345 Gothenburg, Sweden, Landspitali Univ Hosp, Dept Internal Med, Reykjavik, Iceland, Sahlgrens Univ Hosp, Transplant Inst, Gothenburg, Sweden, Skane Univ Hosp, Dept Gastroenterol, Lund, Swedenen
dc.identifier.journalTransplantationen
dc.rights.accessLandspitali Access - LSH-aðganguren
html.description.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.
html.description.abstractAdult 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).
html.description.abstractRenal 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).
html.description.abstractPretransplant renal impairment is a predictor of cardiac event after liver transplantation together with prolonged QTc interval.


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