BACKGROUND: Cardiovascular events represent a major source of morbidity and mortality after liver transplantation and will likely increase given the aging population and nonalcoholic fatty liver disease as a leading indication for transplant. The optimal cardiovascular risk stratification approach in this evolving patient population remains unclear. The aims of this systematic review are to: (1) refine the definition, (2) characterize the incidence, and (3) identify risk factors for cardiovascular events post-liver transplantation. Additionally, we evaluated performance characteristics of different cardiac testing modalities. METHODS: MEDLINE via PubMed, EMBASE, Web of Science, and Scopus were searched for studies published between 2002 and 2016 (model of end-stage liver disease era). Two authors independently reviewed articles to select eligible studies and performed data abstraction. RESULTS: Twenty-nine studies representing 57 493 patients from 26 unique cohorts were included. Definitions of cardiovascular outcomes were highly inconsistent. Incidence rates were widely variable: 1% to 41% for outcomes of 6 months or shorter and 0% to 31% for outcomes longer than 6 months. Multivariate analyses demonstrated that older age and history of cardiac disease were the most consistent predictors of cardiovascular events posttransplant (significant in 8/23 and 7/22, studies, respectively). Predictive capacity of various cardiac imaging modalities was also discrepant. CONCLUSIONS: The true incidence of cardiovascular outcomes post-liver transplant remains unknown in large part due to lack of consensus regarding outcome definition. Overall, poor data quality and gaps in knowledge limit the ability to clearly identify predictors of outcomes, but existing data support a more aggressive risk stratification protocol for patients of advanced age and/or with preexisting cardiac disease.
BACKGROUND: Cardiovascular events represent a major source of morbidity and mortality after liver transplantation and will likely increase given the aging population and nonalcoholic fatty liver disease as a leading indication for transplant. The optimal cardiovascular risk stratification approach in this evolving patient population remains unclear. The aims of this systematic review are to: (1) refine the definition, (2) characterize the incidence, and (3) identify risk factors for cardiovascular events post-liver transplantation. Additionally, we evaluated performance characteristics of different cardiac testing modalities. METHODS: MEDLINE via PubMed, EMBASE, Web of Science, and Scopus were searched for studies published between 2002 and 2016 (model of end-stage liver disease era). Two authors independently reviewed articles to select eligible studies and performed data abstraction. RESULTS: Twenty-nine studies representing 57 493 patients from 26 unique cohorts were included. Definitions of cardiovascular outcomes were highly inconsistent. Incidence rates were widely variable: 1% to 41% for outcomes of 6 months or shorter and 0% to 31% for outcomes longer than 6 months. Multivariate analyses demonstrated that older age and history of cardiac disease were the most consistent predictors of cardiovascular events posttransplant (significant in 8/23 and 7/22, studies, respectively). Predictive capacity of various cardiac imaging modalities was also discrepant. CONCLUSIONS: The true incidence of cardiovascular outcomes post-liver transplant remains unknown in large part due to lack of consensus regarding outcome definition. Overall, poor data quality and gaps in knowledge limit the ability to clearly identify predictors of outcomes, but existing data support a more aggressive risk stratification protocol for patients of advanced age and/or with preexisting cardiac disease.
Authors: Daniel Jodocy; Susanne Abbrederis; Ivo W Graziadei; Wolfgang Vogel; Otmar Pachinger; Gudrun M Feuchtner; Werner Jaschke; Guy Friedrich Journal: Eur J Radiol Date: 2011-06-12 Impact factor: 3.528
Authors: Daniela E Oprea-Lager; Bastiaan J Sorgdrager; J Wouter Jukema; Roderick W C Scherptong; Jan Ringers; Minneke J Coenraad; Bart van Hoek; Marcel P M Stokkel Journal: Liver Transpl Date: 2011-03 Impact factor: 5.799
Authors: M Senzolo; M Bassanello; A Graziotto; P Zucchetta; U Cillo; G Maraglino; M Loreno; F Bellotto; G Davià; P Burra Journal: Transplant Proc Date: 2008 Jul-Aug Impact factor: 1.066
Authors: Anas Safadi; Mohamed Homsi; Waddah Maskoun; Kathleen A Lane; Inder Singh; S G Sawada; Jo Mahenthiran Journal: Circulation Date: 2009-09-14 Impact factor: 29.690
Authors: Mohammed Eslam; Shiv K Sarin; Vincent Wai-Sun Wong; Jian-Gao Fan; Takumi Kawaguchi; Sang Hoon Ahn; Ming-Hua Zheng; Gamal Shiha; Yusuf Yilmaz; Rino Gani; Shahinul Alam; Yock Young Dan; Jia-Horng Kao; Saeed Hamid; Ian Homer Cua; Wah-Kheong Chan; Diana Payawal; Soek-Siam Tan; Tawesak Tanwandee; Leon A Adams; Manoj Kumar; Masao Omata; Jacob George Journal: Hepatol Int Date: 2020-10-01 Impact factor: 6.047
Authors: Nia Adeniji; Vinodhini Arjunan; Vijay Prabhakar; Ajitha Mannalithara; Tara Ghaziani; Aijaz Ahmed; Paul Kwo; Mindie Nguyen; Marc L Melcher; Ronald W Busuttil; Sander S Florman; Brandy Haydel; Richard M Ruiz; Goran B Klintmalm; David D Lee; C Burcin Taner; Maarouf A Hoteit; Elizabeth C Verna; Karim J Halazun; Amit D Tevar; Abhinav Humar; William C Chapman; Neeta Vachharajani; Federico Aucejo; Trevor L Nydam; James F Markmann; Constance Mobley; Mark Ghobrial; Alan N Langnas; Carol A Carney; Jennifer Berumen; Gabriel T Schnickel; Debra L Sudan; Johnny C Hong; Abbas Rana; Christopher M Jones; Thomas M Fishbein; Vatche Agopian; Renumathy Dhanasekaran Journal: Liver Transpl Date: 2021-03-01 Impact factor: 5.799