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Heart transplantation in patients with liver cirrhosis
- Source :
- European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery. 34(2)
- Publication Year :
- 2007
-
Abstract
- Objective: Liver cirrhosis is considered to be a contraindication to heart transplantation. However, the clinical outcome of heart transplantation in patients with liver cirrhosis has not been reported. Here, we sought to evaluate the clinical outcome of heart transplantation in cirrhoticpatients.Methods:Datawere collectedby retrospective chartreview. Patientswithliver cirrhosisatthe timeof transplantationwere included. Results: Between 1987 and 2007, 12 patients with liver cirrhosis underwent heart transplantation at the authors’ hospital. Diagnosis of liver cirrhosis was based on preoperative abdominal sonography in five, autopsy in five, and laparotomy in two patients. Causes of heart failure were dilated cardiomyopathy in four, coronary artery disease in three, congenital heart disease in three and valvular heart disease in two patients. Causes of liver cirrhosis were alcoholism in two, cardiac in seven, and unknown in three patients. The Child classification was class A in three, class B in five and class C in four patients. Overall, the hospital mortality rate was 50% and major in-hospital complications occurred in nine patients (75%). Patients with non-cardiomyopathy diagnosis, previous sternotomy, and massive ascites had a high hospital mortality rate. The median follow-up duration was 33.5 months. There was no late death. Late post-transplant complications occurred in four patients and there was no event of liver dysfunction. All survivors were in Child class A at outpatient follow-up. Conclusions: Although there was high mortality and morbidity, patients with end-stage heart failure and liver cirrhosis can be considered for heart transplantation with careful case selection. # 2008 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.
- Subjects :
- Pulmonary and Respiratory Medicine
Adult
Liver Cirrhosis
Male
medicine.medical_specialty
Cirrhosis
Heart disease
Adolescent
medicine.medical_treatment
Severity of Illness Index
Coronary artery disease
medicine
Humans
Heart transplantation
Heart Failure
Postoperative Care
business.industry
valvular heart disease
Dilated cardiomyopathy
General Medicine
Middle Aged
medicine.disease
Surgery
Transplantation
Treatment Outcome
Heart failure
Heart Transplantation
Female
Cardiology and Cardiovascular Medicine
business
Epidemiologic Methods
Immunosuppressive Agents
Subjects
Details
- ISSN :
- 10107940
- Volume :
- 34
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
- Accession number :
- edsair.doi.dedup.....d0082ceb860b31662511ccbaf611093a