Reversible non-ischaemic cardiomyopathy and left ventricular dysfunction after liver transplantation: A single-centre experience

Maria Yataco, Thomas Difato, Johannes Bargehr, Barry G. Rosser, Tushar C Patel, Jorge F. Trejo-Gutierrez, Surakit Pungpapong, C. Burcin Taner, Jaime Aranda-Michel

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background & Aims: Non-ischaemic cardiomyopathy (NIC) is an early complication of liver transplantation (LT). Our aims were to define the prevalence, associated clinical factors, and prognosis of this condition. Methods: A retrospective study was performed on patients undergoing LT at our institution from January 2005 to December 2012. Patients who developed NIC were identified. Data collected included demographic and clinical data. Results: A total 1460 transplants were performed in this period and seventeen patients developed NIC. Pretransplant median QTc interval was 459 (range, 405-530), and median E/A ratio was 1 (range, 0.71-1.67). Fourteen patients (82%) were severely malnourished and required nutritional support. Thirteen patients (76%) had renal insufficiency. Median time to onset was 2 days post-transplant (range, 0-20). Echocardiograms showed global left ventricular hypokinesis and a decrease in ejection fraction (EF) from a median of 65% (range, 50-81) pretransplant to a median of 21% (range, 15-32). Median raw model for end-stage liver disease (MELD) score was 29 in patients with NIC vs. 18 in patients without cardiomyopathy (P = 0.01). There was no significant difference between recipients with NIC vs. recipients without cardiomyopathy regarding donor age, donor risk index, and cold and warm ischaemia time. Recovery of cardiac function occurred in 16 patients, with a median EF of 44% (range, 25-65%) at the time of discharge. The last echocardiogram available showed a median EF of 59% (range, 49-73%). One-year survival of NIC patients was 94.1%. Conclusion: Non-ischaemic cardiomyopathy is a rare complication after LT. Patients with NIC are critically ill, with high MELD score, and severe malnutrition.

Original languageEnglish (US)
JournalLiver International
Volume34
Issue number6
DOIs
StatePublished - 2014

Fingerprint

Left Ventricular Dysfunction
Cardiomyopathies
Liver Transplantation
End Stage Liver Disease
Tissue Donors
Transplants
Cold Ischemia
Warm Ischemia
Nutritional Support
Recovery of Function
Critical Illness
Malnutrition
Renal Insufficiency
Retrospective Studies
Demography
Survival

Keywords

  • Cardiomyopathy
  • Cardiovascular complications
  • Cirrhosis
  • Heart failure
  • Liver transplant

ASJC Scopus subject areas

  • Hepatology
  • Medicine(all)

Cite this

Reversible non-ischaemic cardiomyopathy and left ventricular dysfunction after liver transplantation : A single-centre experience. / Yataco, Maria; Difato, Thomas; Bargehr, Johannes; Rosser, Barry G.; Patel, Tushar C; Trejo-Gutierrez, Jorge F.; Pungpapong, Surakit; Taner, C. Burcin; Aranda-Michel, Jaime.

In: Liver International, Vol. 34, No. 6, 2014.

Research output: Contribution to journalArticle

Yataco, Maria ; Difato, Thomas ; Bargehr, Johannes ; Rosser, Barry G. ; Patel, Tushar C ; Trejo-Gutierrez, Jorge F. ; Pungpapong, Surakit ; Taner, C. Burcin ; Aranda-Michel, Jaime. / Reversible non-ischaemic cardiomyopathy and left ventricular dysfunction after liver transplantation : A single-centre experience. In: Liver International. 2014 ; Vol. 34, No. 6.
@article{6e3dada1093d4972a43cddd23b4681ab,
title = "Reversible non-ischaemic cardiomyopathy and left ventricular dysfunction after liver transplantation: A single-centre experience",
abstract = "Background & Aims: Non-ischaemic cardiomyopathy (NIC) is an early complication of liver transplantation (LT). Our aims were to define the prevalence, associated clinical factors, and prognosis of this condition. Methods: A retrospective study was performed on patients undergoing LT at our institution from January 2005 to December 2012. Patients who developed NIC were identified. Data collected included demographic and clinical data. Results: A total 1460 transplants were performed in this period and seventeen patients developed NIC. Pretransplant median QTc interval was 459 (range, 405-530), and median E/A ratio was 1 (range, 0.71-1.67). Fourteen patients (82{\%}) were severely malnourished and required nutritional support. Thirteen patients (76{\%}) had renal insufficiency. Median time to onset was 2 days post-transplant (range, 0-20). Echocardiograms showed global left ventricular hypokinesis and a decrease in ejection fraction (EF) from a median of 65{\%} (range, 50-81) pretransplant to a median of 21{\%} (range, 15-32). Median raw model for end-stage liver disease (MELD) score was 29 in patients with NIC vs. 18 in patients without cardiomyopathy (P = 0.01). There was no significant difference between recipients with NIC vs. recipients without cardiomyopathy regarding donor age, donor risk index, and cold and warm ischaemia time. Recovery of cardiac function occurred in 16 patients, with a median EF of 44{\%} (range, 25-65{\%}) at the time of discharge. The last echocardiogram available showed a median EF of 59{\%} (range, 49-73{\%}). One-year survival of NIC patients was 94.1{\%}. Conclusion: Non-ischaemic cardiomyopathy is a rare complication after LT. Patients with NIC are critically ill, with high MELD score, and severe malnutrition.",
keywords = "Cardiomyopathy, Cardiovascular complications, Cirrhosis, Heart failure, Liver transplant",
author = "Maria Yataco and Thomas Difato and Johannes Bargehr and Rosser, {Barry G.} and Patel, {Tushar C} and Trejo-Gutierrez, {Jorge F.} and Surakit Pungpapong and Taner, {C. Burcin} and Jaime Aranda-Michel",
year = "2014",
doi = "10.1111/liv.12501",
language = "English (US)",
volume = "34",
journal = "Liver International",
issn = "1478-3223",
publisher = "Wiley-Blackwell",
number = "6",

}

TY - JOUR

T1 - Reversible non-ischaemic cardiomyopathy and left ventricular dysfunction after liver transplantation

T2 - A single-centre experience

AU - Yataco, Maria

AU - Difato, Thomas

AU - Bargehr, Johannes

AU - Rosser, Barry G.

AU - Patel, Tushar C

AU - Trejo-Gutierrez, Jorge F.

AU - Pungpapong, Surakit

AU - Taner, C. Burcin

AU - Aranda-Michel, Jaime

PY - 2014

Y1 - 2014

N2 - Background & Aims: Non-ischaemic cardiomyopathy (NIC) is an early complication of liver transplantation (LT). Our aims were to define the prevalence, associated clinical factors, and prognosis of this condition. Methods: A retrospective study was performed on patients undergoing LT at our institution from January 2005 to December 2012. Patients who developed NIC were identified. Data collected included demographic and clinical data. Results: A total 1460 transplants were performed in this period and seventeen patients developed NIC. Pretransplant median QTc interval was 459 (range, 405-530), and median E/A ratio was 1 (range, 0.71-1.67). Fourteen patients (82%) were severely malnourished and required nutritional support. Thirteen patients (76%) had renal insufficiency. Median time to onset was 2 days post-transplant (range, 0-20). Echocardiograms showed global left ventricular hypokinesis and a decrease in ejection fraction (EF) from a median of 65% (range, 50-81) pretransplant to a median of 21% (range, 15-32). Median raw model for end-stage liver disease (MELD) score was 29 in patients with NIC vs. 18 in patients without cardiomyopathy (P = 0.01). There was no significant difference between recipients with NIC vs. recipients without cardiomyopathy regarding donor age, donor risk index, and cold and warm ischaemia time. Recovery of cardiac function occurred in 16 patients, with a median EF of 44% (range, 25-65%) at the time of discharge. The last echocardiogram available showed a median EF of 59% (range, 49-73%). One-year survival of NIC patients was 94.1%. Conclusion: Non-ischaemic cardiomyopathy is a rare complication after LT. Patients with NIC are critically ill, with high MELD score, and severe malnutrition.

AB - Background & Aims: Non-ischaemic cardiomyopathy (NIC) is an early complication of liver transplantation (LT). Our aims were to define the prevalence, associated clinical factors, and prognosis of this condition. Methods: A retrospective study was performed on patients undergoing LT at our institution from January 2005 to December 2012. Patients who developed NIC were identified. Data collected included demographic and clinical data. Results: A total 1460 transplants were performed in this period and seventeen patients developed NIC. Pretransplant median QTc interval was 459 (range, 405-530), and median E/A ratio was 1 (range, 0.71-1.67). Fourteen patients (82%) were severely malnourished and required nutritional support. Thirteen patients (76%) had renal insufficiency. Median time to onset was 2 days post-transplant (range, 0-20). Echocardiograms showed global left ventricular hypokinesis and a decrease in ejection fraction (EF) from a median of 65% (range, 50-81) pretransplant to a median of 21% (range, 15-32). Median raw model for end-stage liver disease (MELD) score was 29 in patients with NIC vs. 18 in patients without cardiomyopathy (P = 0.01). There was no significant difference between recipients with NIC vs. recipients without cardiomyopathy regarding donor age, donor risk index, and cold and warm ischaemia time. Recovery of cardiac function occurred in 16 patients, with a median EF of 44% (range, 25-65%) at the time of discharge. The last echocardiogram available showed a median EF of 59% (range, 49-73%). One-year survival of NIC patients was 94.1%. Conclusion: Non-ischaemic cardiomyopathy is a rare complication after LT. Patients with NIC are critically ill, with high MELD score, and severe malnutrition.

KW - Cardiomyopathy

KW - Cardiovascular complications

KW - Cirrhosis

KW - Heart failure

KW - Liver transplant

UR - http://www.scopus.com/inward/record.url?scp=84902548997&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84902548997&partnerID=8YFLogxK

U2 - 10.1111/liv.12501

DO - 10.1111/liv.12501

M3 - Article

C2 - 24529030

AN - SCOPUS:84902548997

VL - 34

JO - Liver International

JF - Liver International

SN - 1478-3223

IS - 6

ER -