Post-liver transplantation myocardial dysfunction

P. Sampathkumar, A. Lerman, B. Y. Kim, B. J. Narr, J. J. Poterucha, L. C. Torsher, D. J. Plevak

Research output: Contribution to journalArticle

59 Scopus citations

Abstract

Patients with end-stage liver disease usually show a hyperdynamic circulatory state. It has previously been reported that patients who develop myocardial depression in the early post-liver transplantation period are more prone to organ failure and death. We reviewed the records of 754 adult patients undergoing liver transplantation at our institution and identified 7 patients who initially showed hyperdynamic circulation, but then developed reversible dilated cardiomyopathy in the early posttransplantation period. All identifiable causes of cardiac dysfunction, such as myocardial ischemia, thyroid dysfunction, and electrolyte imbalances, were excluded. Left ventricular ejection fraction decreased from a preoperative median baseline of 60% to 20% (P = .02), with four-chamber dilatation on echocardiogram. All these patients required supportive care, including mechanical ventilation, afterload reduction, inotropic support, and monitoring in the intensive care unit. Cardiac function subsequently improved in all patients, with ejection fraction increasing to a median of 50%. All patients were discharged from the hospital. At a median follow-up of 15 months, there was no recurrence of heart failure. The increased peripheral resistance seen after successful liver transplantation may be an important causative factor.

Original languageEnglish (US)
Pages (from-to)399-403
Number of pages5
JournalLiver Transplantation and Surgery
Volume4
Issue number5
DOIs
StatePublished - 1998

ASJC Scopus subject areas

  • Surgery
  • Hepatology

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