| Cardiac dysfunction during liver transplantation: incidence and preoperative predictors. | |
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MedLine Citation:
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PMID: 18580469 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Transplantation Volume: 85 ISSN: 0041-1337 ISO Abbreviation: Transplantation Publication Date: 2008 Jun |
Date Detail:
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Created Date: 2008-06-26 Completed Date: 2008-08-13 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0132144 Medline TA: Transplantation Country: United States |
Other Details:
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Languages: eng Pagination: 1766-72 Citation Subset: IM |
Affiliation:
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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:
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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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