Fouad et al identified risk factors for cardiac complications after liver transplantation. These can help to identify a patient who may benefit from more aggressive management. The authors are from the University of Calgary, Menoufiya University (Egypt), and the University of Alberta.
Patient selection: liver transplant, age >= 40 years (range 40 to 75 years, median 56 years)
Outcome: cardiac complications within 6 months
Cardiac complications included:
(1) pulmonary edema (including heart failure)
(2) arrhythmia (ventricular tachycardia, atrial fibrillation, other)
(3) pulmonary hypertension
(4) pericardial effusion
(5) right atrial thrombus
(6) myocardial infarction
(7) cardiac death
Risk factors for cardiac complications from multivariate analysis:
(1) adverse intraoperative cardiovascular events (OR 5.7)
(2) history of cardiac disease (OR 2.4)
(3) pretransplant iMELD score (OR 1.08 per unit)
The risk for cardiac complications increases with the number of risk factors present.
