Preoperative echocardiographic differences and transplant outcomes among patients receiving simultaneous liver-kidney versus liver transplant alone

Research output: Contribution to journalArticle

Abstract

Objectives: Liver transplant and simultaneous liver-kidney transplant are major surgeries performed on high-risk individuals with end-stage liver disease and end-stage renal disease. We sought to examine the relationship between pretransplant echocardiographic parameters and outcomes in our simultaneous liver-kidney transplant and liver transplant-alone populations. Materials and Methods: In our retrospective analysis, we included adult patients who underwent index transplant from January 1, 2010 to December 31, 2015 at Johns Hopkins Comprehensive Transplant Center. Results: Our study included 312 patients, 266 who underwent liver transplant alone and 46 who underwent simultaneous liver-kidney transplant. Baseline population demographics were similar in both groups of patients. Primary diagnosis at transplant was similar in both groups except that patients undergoing liver transplant were more likely to have a diagnosis of hepatocellular carcinoma, whereas those undergoing simultaneous liver-kidney transplant were more likely to have polycystic kidney disease. Within the liver transplant-alone group, the strongest demographic predictor of poor outcome was age at transplant. The strongest echocardiographic predictors were related to elevated left ventricular ejection fraction and right ventricular systolic pressure. Conclusions: In our investigation regarding whether the pretransplant cardiovascular evaluation predicted outcomes for patients undergoing liver transplant alone and patients undergoing simultaneous liver-kidney transplant, we found that elevations in right ventricular systolic pressure and left ventricular ejection fraction may be associated with poor outcomes in the posttransplant period.

Original languageEnglish (US)
Pages (from-to)9-13
Number of pages5
JournalExperimental and Clinical Transplantation
Volume16
DOIs
StatePublished - Mar 1 2018

Fingerprint

Transplants
Kidney
Liver
Ventricular Pressure
Stroke Volume
Demography
Blood Pressure
Polycystic Kidney Diseases
End Stage Liver Disease
Population
Chronic Kidney Failure
Hepatocellular Carcinoma

Keywords

  • Cardiac echocardiography
  • Left ventricular ejection fraction
  • Right ventricular systolic pressure

ASJC Scopus subject areas

  • Transplantation

Cite this

@article{c99a7352b33b469b9801eaef90abfa2c,
title = "Preoperative echocardiographic differences and transplant outcomes among patients receiving simultaneous liver-kidney versus liver transplant alone",
abstract = "Objectives: Liver transplant and simultaneous liver-kidney transplant are major surgeries performed on high-risk individuals with end-stage liver disease and end-stage renal disease. We sought to examine the relationship between pretransplant echocardiographic parameters and outcomes in our simultaneous liver-kidney transplant and liver transplant-alone populations. Materials and Methods: In our retrospective analysis, we included adult patients who underwent index transplant from January 1, 2010 to December 31, 2015 at Johns Hopkins Comprehensive Transplant Center. Results: Our study included 312 patients, 266 who underwent liver transplant alone and 46 who underwent simultaneous liver-kidney transplant. Baseline population demographics were similar in both groups of patients. Primary diagnosis at transplant was similar in both groups except that patients undergoing liver transplant were more likely to have a diagnosis of hepatocellular carcinoma, whereas those undergoing simultaneous liver-kidney transplant were more likely to have polycystic kidney disease. Within the liver transplant-alone group, the strongest demographic predictor of poor outcome was age at transplant. The strongest echocardiographic predictors were related to elevated left ventricular ejection fraction and right ventricular systolic pressure. Conclusions: In our investigation regarding whether the pretransplant cardiovascular evaluation predicted outcomes for patients undergoing liver transplant alone and patients undergoing simultaneous liver-kidney transplant, we found that elevations in right ventricular systolic pressure and left ventricular ejection fraction may be associated with poor outcomes in the posttransplant period.",
keywords = "Cardiac echocardiography, Left ventricular ejection fraction, Right ventricular systolic pressure",
author = "Mazumder, {Nik R.} and Russell, {Stuart D.} and Aliaksei Pustavoitau and Matthews Chacko and Nicole Rizkalla and Behnam Saberi and Benjamin Philosophe and Cameron, {Andrew M} and Ahmet Gurakar and Fizza Naqvi",
year = "2018",
month = "3",
day = "1",
doi = "10.6002/ect.TOND-TDTD2017.L34",
language = "English (US)",
volume = "16",
pages = "9--13",
journal = "Experimental and Clinical Transplantation",
issn = "1304-0855",
publisher = "Baskent University",

}

TY - JOUR

T1 - Preoperative echocardiographic differences and transplant outcomes among patients receiving simultaneous liver-kidney versus liver transplant alone

AU - Mazumder, Nik R.

AU - Russell, Stuart D.

AU - Pustavoitau, Aliaksei

AU - Chacko, Matthews

AU - Rizkalla, Nicole

AU - Saberi, Behnam

AU - Philosophe, Benjamin

AU - Cameron, Andrew M

AU - Gurakar, Ahmet

AU - Naqvi, Fizza

PY - 2018/3/1

Y1 - 2018/3/1

N2 - Objectives: Liver transplant and simultaneous liver-kidney transplant are major surgeries performed on high-risk individuals with end-stage liver disease and end-stage renal disease. We sought to examine the relationship between pretransplant echocardiographic parameters and outcomes in our simultaneous liver-kidney transplant and liver transplant-alone populations. Materials and Methods: In our retrospective analysis, we included adult patients who underwent index transplant from January 1, 2010 to December 31, 2015 at Johns Hopkins Comprehensive Transplant Center. Results: Our study included 312 patients, 266 who underwent liver transplant alone and 46 who underwent simultaneous liver-kidney transplant. Baseline population demographics were similar in both groups of patients. Primary diagnosis at transplant was similar in both groups except that patients undergoing liver transplant were more likely to have a diagnosis of hepatocellular carcinoma, whereas those undergoing simultaneous liver-kidney transplant were more likely to have polycystic kidney disease. Within the liver transplant-alone group, the strongest demographic predictor of poor outcome was age at transplant. The strongest echocardiographic predictors were related to elevated left ventricular ejection fraction and right ventricular systolic pressure. Conclusions: In our investigation regarding whether the pretransplant cardiovascular evaluation predicted outcomes for patients undergoing liver transplant alone and patients undergoing simultaneous liver-kidney transplant, we found that elevations in right ventricular systolic pressure and left ventricular ejection fraction may be associated with poor outcomes in the posttransplant period.

AB - Objectives: Liver transplant and simultaneous liver-kidney transplant are major surgeries performed on high-risk individuals with end-stage liver disease and end-stage renal disease. We sought to examine the relationship between pretransplant echocardiographic parameters and outcomes in our simultaneous liver-kidney transplant and liver transplant-alone populations. Materials and Methods: In our retrospective analysis, we included adult patients who underwent index transplant from January 1, 2010 to December 31, 2015 at Johns Hopkins Comprehensive Transplant Center. Results: Our study included 312 patients, 266 who underwent liver transplant alone and 46 who underwent simultaneous liver-kidney transplant. Baseline population demographics were similar in both groups of patients. Primary diagnosis at transplant was similar in both groups except that patients undergoing liver transplant were more likely to have a diagnosis of hepatocellular carcinoma, whereas those undergoing simultaneous liver-kidney transplant were more likely to have polycystic kidney disease. Within the liver transplant-alone group, the strongest demographic predictor of poor outcome was age at transplant. The strongest echocardiographic predictors were related to elevated left ventricular ejection fraction and right ventricular systolic pressure. Conclusions: In our investigation regarding whether the pretransplant cardiovascular evaluation predicted outcomes for patients undergoing liver transplant alone and patients undergoing simultaneous liver-kidney transplant, we found that elevations in right ventricular systolic pressure and left ventricular ejection fraction may be associated with poor outcomes in the posttransplant period.

KW - Cardiac echocardiography

KW - Left ventricular ejection fraction

KW - Right ventricular systolic pressure

UR - http://www.scopus.com/inward/record.url?scp=85044131012&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85044131012&partnerID=8YFLogxK

U2 - 10.6002/ect.TOND-TDTD2017.L34

DO - 10.6002/ect.TOND-TDTD2017.L34

M3 - Article

C2 - 29527983

AN - SCOPUS:85044131012

VL - 16

SP - 9

EP - 13

JO - Experimental and Clinical Transplantation

JF - Experimental and Clinical Transplantation

SN - 1304-0855

ER -