| Severe left-sided heart failure early after liver transplantation. | |
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MedLine Citation:
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PMID: 19790149 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Left-sided heart failure (LHF) after liver transplantation (LT) is rare and poorly understood. We performed a case-control study. We reviewed the data of all patients with LHF after LT at our center from November 2000 to July 2007. Each case was matched to 1 LT control without LHF for age, sex, date of transplantation, and liver disease. Twenty of 599 patients developed LHF (3.3%). Pretransplant cardiovascular characteristics and risk factors were similar in cases and controls, except for the prevalence of left ventricular enlargement, which was greater in controls. At the time of diagnosis, the median left ventricular ejection fraction was 25% in cases, and increased afterload was documented by markedly elevated vascular resistances. The prevalence of infection at the time of LHF in cases was higher (55%) than in controls (10%, P = 0.02). The reported causes of LHF were infection [bacterial (n = 1) or viral (n = 7)], intraoperative cardiac arrest (n = 2), and unknown (n = 10). In comparison with their controls, cases with immediate postoperative LHF (day 0) did not have a higher Model for End-Stage Liver Disease (MELD) score (15 versus 21.5) or infection prevalence rate (17% versus 34%), whereas those with later onset LHF had a significantly higher MELD score (25.5 versus 17, P = 0.01) and infection prevalence rate (71% versus 0%, P = 0.002). Mortality was 45% in cases versus 0% in controls (P = 0.004), and the 11 cases who survived recovered from LHF. In conclusion, LHF after LT carries a high mortality risk and may have different causes. Except for immediate postoperative cases, an infection and an elevated MELD score appear to be determinant. |
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Authors:
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Fr??d??ric Schnell; Erwan Donal; Richard Lorho; Sylvain Lavou??; Arnaud Gacouin; Philippe Compagnon; Karim Boudjema; Philippe Mabo; Yves Le Tulzo; Christophe Camus |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society Volume: 15 ISSN: 1527-6473 ISO Abbreviation: Liver Transpl. Publication Date: 2009 Oct |
Date Detail:
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Created Date: 2009-10-05 Completed Date: 2009-12-17 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100909185 Medline TA: Liver Transpl Country: United States |
Other Details:
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Languages: eng Pagination: 1296-305 Citation Subset: IM |
Copyright Information:
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Copyright 2009 AASLD |
Affiliation:
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Service de Cardiologie et Maladies Vasculaires (Centre d'Investigation Clinique-Innovations Technologiques 804, Institut National de la Sant?? et de la Recherche M??dicale Unit?? 642), Centre Hospitalier Universitaire Rennes, Rennes, France. |
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Cardiovascular System Case-Control Studies Electrocardiography Female Heart Failure / diagnosis*, etiology* Heart Ventricles / pathology Humans Infection Liver Transplantation / adverse effects*, methods* Male Middle Aged Postoperative Period Prevalence Retrospective Studies Risk Factors Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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