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Prevalence and Impact of Cirrhotic Cardiomyopathy on Adverse Outcomes Following Liver Transplantation: A Systematic

Ramish Sumbal1,2, Raja T Yaseen Khan1, Muhammad Q Panezai1

  • 1Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan.

Journal of Clinical and Experimental Hepatology
|May 11, 2026
PubMed

Insights

Cirrhotic cardiomyopathy (CCM) affects 35.3% of liver transplant recipients, increasing risks for major adverse cardiovascular events and heart failure. Pretransplant CCM is linked to post-transplant complications but not mortality.

Area of Science:

  • Cardiology
  • Hepatology
  • Transplantation Medicine

Background:

  • Cirrhotic cardiomyopathy (CCM) affects 30-50% of liver transplant patients.
  • CCM may contribute to post-transplant complications like mortality and heart failure (HF).
  • Existing research presents conflicting findings on CCM's impact, necessitating further investigation.

Purpose of the Study:

  • To conduct a systematic review and meta-analysis.
  • To determine the prevalence of CCM in liver transplant recipients.
  • To investigate the association between pretransplant CCM and post-transplant outcomes.

Main Methods:

  • Systematic literature search of PubMed, Google Scholar, and Cochrane databases.
  • Inclusion of 7 studies with 1475 patients, assessed using the Newcastle-Ottawa score.
  • Meta-analysis performed using Comprehensive Meta-analysis and Review Manager software to pool prevalence and hazard ratios (HR).

Main Results:

  • The pooled prevalence of CCM among liver transplant recipients was 35.3% (95% CI: 19.7%-54.8%).
  • Pretransplant CCM significantly correlated with post-transplant major adverse cardiovascular events (MACE, HR: 2.14), heart failure (HF, HR: 2.58), arrhythmias (HR: 2.47), and atrial fibrillation (HR: 3.20).
  • No significant association was found between CCM and post-transplant mortality.

Conclusions:

  • Approximately 35.3% of liver transplant recipients have underlying CCM.
  • Pretransplant CCM is a significant predictor of post-transplant MACE, HF, arrhythmias, and atrial fibrillation.
  • CCM does not appear to be significantly related to post-transplant mortality.
Abstract

Keywords:
cirrhotic cardiomyopathyliver transplantmeta-analysisoutcomesprevalence

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