https://doi.org/10.4081/monaldi.2024.2963
Clinical and echocardiographic predictors of outcome in liver transplant patients
Submitted: February 21, 2024
Accepted: April 9, 2024
Published: August 28, 2024
Accepted: April 9, 2024
Abstract Views: 467
PDF_EARLY VIEW: 91
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Liver transplant (LT) candidates undergo transthoracic echocardiography (TTE) before surgery to assess cardiac function and evaluate the echocardiographic probability of pulmonary hypertension (PHT). The improvement of pulmonary artery systolic pressure (PAPS) after transplant is associated with higher survival rates in patients with mild or moderate PHT. Although studies analyze the outcomes of LT in patients treated for PHT, the prognostic value of PAPS in patients without PHT in the follow-up is unknown. The aim of our study is to evaluate pre- and post-LT cardiac function, right ventricular function, pulmonary artery pressure, and their association with long-term mortality. 102 patients who underwent LT between 2011 and 2018 were compared for echocardiographic and hemodynamic parameters pre- and post-LT. After LT, systolic blood pressure, heart rate (HR), and PASP significantly increased, while tricuspid annular plane systolic excursion/PAPS decreased. Moreover, the higher difference in HR and PASP between pre- and post-LT was highlighted in those patients who died during the follow-up period after LT. Among all the parameters tested, in the multi-variable Cox regression for mortality, left ventricular ejection fraction and PASP difference were predictors of mortality. This study highlights the importance of TTE in LT screening as a tool to stratify patients at higher risk of death due to advanced cirrhotic cardiomyopathy and the importance of the change of echocardiographic parameters, in particular right and left ventricular hemodynamics, during the follow-up period. These parameters could be used to guide a more aggressive therapy.
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Ethics Approval
This study was approved by the Ethical Committee of King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia (protocol number 2191217).How to Cite
Landi, Irene, Suliman Alharbil, Abdullah Alfehaid, Sarah Aldosari, Abdalla Eltayeb A.A, Nadiah Alruwaili, Roberto Troisi, Domenico Galzerano, Mario Pirisi, and Olga Vriz. 2024. “Clinical and Echocardiographic Predictors of Outcome in Liver Transplant Patients”. Monaldi Archives for Chest Disease, August. https://doi.org/10.4081/monaldi.2024.2963.
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