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Relation of Preoperative and Postoperative Echocardiographic Parameters With Rejection and Mortality in Liver

Kerem Can Yilmaz1, Orcun Ciftci, Arzu Neslihan Akgun

  • 1>From the Cardiology Department, Baskent University Faculty of Medicine, Ankara, Turkey.

Experimental and Clinical Transplantation : Official Journal of the Middle East Society for Organ Transplantation
|May 24, 2018
PubMed

Insights

Echocardiography parameters like systolic pulmonary arterial pressure and tricuspid annular plane systolic excursion predict survival after liver transplant. These measurements help assess right ventricular function and guide patient management.

Area of Science:

  • Cardiology
  • Hepatology
  • Transplant Surgery

Background:

  • End-stage liver disease (ESLD) significantly impacts cardiac function, leading to conditions like high-output heart failure and pulmonary hypertension.
  • Cardiac dysfunctions in ESLD patients affect perioperative survival following liver transplantation.
  • Right heart abnormalities are common in ESLD and can influence transplant outcomes.

Purpose of the Study:

  • To investigate the association between preoperative and postoperative echocardiographic parameters and outcomes in liver transplant recipients.
  • To determine if specific right heart parameters, including tricuspid regurgitation and pulmonary arterial pressure, correlate with liver transplant rejection and mortality.

Main Methods:

  • Retrospective analysis of 64 adult patients who underwent liver transplantation between January 2011 and March 2017.
  • Evaluation of echocardiographic images taken immediately before and after liver transplant.
  • Patients were grouped based on liver rejection status and mortality for comparative analysis.

Main Results:

  • No significant differences in demographic or laboratory data were found between patients with and without liver rejection.
  • Survival analysis revealed statistically significant differences in systolic pulmonary arterial pressure (P=.005), tricuspid annular plane systolic excursion (P=.001), and postoperative right ventricular width (P=.01) between survivors and non-survivors.
  • Echocardiographic parameters related to right heart function showed a strong association with patient survival post-liver transplant.

Conclusions:

  • Echocardiography is a valuable, accessible tool for assessing right ventricular function and tricuspid regurgitation in liver transplant patients.
  • Preoperative and postoperative echocardiographic findings, particularly those related to pulmonary arterial pressure and right ventricular function, can predict survival.
  • Echocardiography can guide management, especially in hemodynamically unstable patients before and after liver transplantation.
Abstract

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