Document Detail


Cardiac dysfunction during liver transplantation: incidence and preoperative predictors.
MedLine Citation:
PMID:  18580469     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The aim was to investigate the cardiac response during liver transplantation (LT) and analyze its relationship with clinical factors, echocardiographic, and hemodynamic findings. METHODS: All patients undergoing LT for cirrhosis from 1998 to 2004 were included. Clinical data, comprehensive echocardiography, hepatic, and right heart hemodynamic measurements were analyzed. During LT patients underwent continuous right-heart pressure monitorization. Measurements 10 min after reperfusion were compared with baseline values. Abnormal cardiac response was defined as a decrease in left ventricular stroke work index despite a rise in pulmonary wedge capillary pressure. Predictors of abnormal cardiac response were investigated using logistic regression. RESULTS: Data were available from 209 patients (mean age 52 (9) yrs; Child A 27; B 93; C 89) with a mean model for end-stage liver disease score 16.3 (4.7). Abnormal cardiac response was observed in 47 (22.5%) patients after reperfusion. Patients who developed this response had hyponatremia, lower central venous pressure, lower pulmonary artery pressure, and lower pulmonary wedged capillary pressure. Abnormal cardiac response was related to a longer postoperative intubation time. CONCLUSION: Abnormal cardiac response is observed during LT and may be a manifestation of occult cirrhotic cardiomyopathy. This finding is underestimated with usual diagnostic tools and could be related to indirect signs of circulatory dysfunction of advanced liver disease.
Authors:
Cristina Ripoll; María-Vega Catalina; Raquel Yotti; Luis Olmedilla; José Pérez-Peña; Oreste Lo Iacono; Diego Rincón; Miguel Angel García-Fernández; Javier Bermejo; Rafael Bañares
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Transplantation     Volume:  85     ISSN:  0041-1337     ISO Abbreviation:  Transplantation     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-06-26     Completed Date:  2008-08-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0132144     Medline TA:  Transplantation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1766-72     Citation Subset:  IM    
Affiliation:
Hepatology and Liver Transplant Unit, Department of Digestive Diseases, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain.
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MeSH Terms
Descriptor/Qualifier:
Adult
Blood Pressure / physiology
Echocardiography, Doppler
Female
Heart / physiopathology*
Humans
Liver Circulation / physiology*
Liver Cirrhosis / physiopathology,  surgery
Liver Transplantation / physiology*,  ultrasonography
Logistic Models
Male
Middle Aged
Predictive Value of Tests
Retrospective Studies
Stroke Volume / physiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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