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Hypertrophic Cardiomyopathy in Liver Transplantation Patients
S-L Pai1, S Aniskevich1, I I Logvinov1
1Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, Florida, USA.
Transplantation Proceedings
|June 9, 2018
Summary
Hypertrophic cardiomyopathy (HCM) patients undergoing liver transplant have worse outcomes if their left ventricular outflow tract gradient is high. A gradient over 60 mm Hg strongly predicts 1-year mortality after transplant.
Area of Science:
- Cardiology
- Hepatology
- Transplantation Medicine
Background:
- Hypertrophic cardiomyopathy (HCM) is a genetic heart condition causing left ventricular hypertrophy.
- HCM can lead to outflow tract obstruction, mitral valve issues, and sudden cardiac death risk.
- Coexisting HCM with end-stage liver disease presents complex cardiovascular challenges.
Purpose of the Study:
- To evaluate the impact of hypertrophic cardiomyopathy on outcomes in patients undergoing liver transplantation.
- To identify predictors of 1-year mortality in liver transplant recipients with HCM.
Main Methods:
- Retrospective analysis of 15 patients with HCM who underwent liver transplantation between 2000 and 2015.
- Examined patient characteristics, comorbidities, echocardiogram data, and sudden cardiac death risk scores.
- Compared preoperative data with 1-year postoperative mortality.
Main Results:
- Maximal left ventricular wall thickness and resting left ventricular outflow tract gradient were significant predictors of 1-year survival (P=.004 for both).
- Preoperative left atrium size and sudden cardiac death risk score did not significantly correlate with 1-year survival.
- A preoperative left ventricular outflow tract gradient exceeding 60 mm Hg was strongly associated with 1-year mortality.
Conclusions:
- The severity of hypertrophic cardiomyopathy, particularly the left ventricular outflow tract gradient, significantly influences survival after liver transplantation.
- Preoperative left ventricular outflow tract gradient is a critical factor for risk stratification in HCM patients awaiting liver transplant.
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