TY - JOUR
T1 - Combined cardiac surgery procedures and liver transplant
T2 - a single-center experience
AU - Jacob, Samuel
AU - Nguyen, Justin H.
AU - El-Sayed Ahmed, Magdy M.
AU - Makey, Ian A.
AU - Haddad, Osama K.
AU - Thomas, Mathew
AU - Sareyyupoglu, Basar
AU - Pham, Si M.
AU - Landolfo, Kevin P.
N1 - Publisher Copyright:
© 2022, The Author(s), under exclusive licence to The Japanese Association for Thoracic Surgery.
PY - 2022/8
Y1 - 2022/8
N2 - Objective: Morbidity and mortality rates associated with liver transplant are high for patients with concomitant heart disease. Traditionally, such cases were considered contraindications for transplant. The objective of our study was to assess the outcome of combined surgical approaches. Methods: A prospectively maintained database was analyzed of patients undergoing cardiac surgery and liver transplant at our institution. Twelve identified patients underwent combined cardiac operation and liver transplant. A control group was created (n = 24) with the same selection criteria. Results: Median patient age was 64.94 years in the combined group vs 63.80 in the control, and in both groups, 58% were male. Left ventricular ejection fraction (0.60), body mass index (30.1), and median (range) score of the Model for End-stage Liver Disease (18 [9–33]) were the same in both groups. The cardiac operations combined with liver transplant were coronary artery bypass grafting, valve replacement procedures, and ascending thoracic aortic aneurysm repair. Piggyback liver transplant was performed for all patients. Survival periods of 1, 5, and 10 years for control vs combined cases were 90 vs 62%, 79 vs 55%, and 70 vs 45%, respectively (P = 0.03). Conclusion: Concomitant cardiac procedure and liver transplant is a valid treatment option and should be considered with risk stratification criteria of the patient with end-stage liver disease and cardiac surgical pathologic characteristics.
AB - Objective: Morbidity and mortality rates associated with liver transplant are high for patients with concomitant heart disease. Traditionally, such cases were considered contraindications for transplant. The objective of our study was to assess the outcome of combined surgical approaches. Methods: A prospectively maintained database was analyzed of patients undergoing cardiac surgery and liver transplant at our institution. Twelve identified patients underwent combined cardiac operation and liver transplant. A control group was created (n = 24) with the same selection criteria. Results: Median patient age was 64.94 years in the combined group vs 63.80 in the control, and in both groups, 58% were male. Left ventricular ejection fraction (0.60), body mass index (30.1), and median (range) score of the Model for End-stage Liver Disease (18 [9–33]) were the same in both groups. The cardiac operations combined with liver transplant were coronary artery bypass grafting, valve replacement procedures, and ascending thoracic aortic aneurysm repair. Piggyback liver transplant was performed for all patients. Survival periods of 1, 5, and 10 years for control vs combined cases were 90 vs 62%, 79 vs 55%, and 70 vs 45%, respectively (P = 0.03). Conclusion: Concomitant cardiac procedure and liver transplant is a valid treatment option and should be considered with risk stratification criteria of the patient with end-stage liver disease and cardiac surgical pathologic characteristics.
KW - Coronary artery disease
KW - Liver disease
KW - Liver transplantation
KW - Risk assessment
KW - Side effects
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U2 - 10.1007/s11748-022-01783-w
DO - 10.1007/s11748-022-01783-w
M3 - Article
C2 - 35146597
AN - SCOPUS:85124352258
SN - 1863-6705
VL - 70
SP - 714
EP - 720
JO - General Thoracic and Cardiovascular Surgery
JF - General Thoracic and Cardiovascular Surgery
IS - 8
ER -