Evaluation of cardiac function before and after liver transplantation

Acosta, F; Morena, Gonzalo de la; Villegas, Manuel; Sansano, T; Reche, M; Beltran, R; Roqués, V; Contreras, Rafael; Robles, R; Bueno, F.S; Ramı́rez, Pablo; Parrilla, Pascual

doi:10.1016/s0041-1345(99)00383-8

Cited by 24 publications

(32 citation statements)

References 5 publications

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“…G-CSF was administered at a dose of 5-10 g/kg, from the end of the chemotherapy until the last leukapheresis. Leukapheresis started when the circulating CD34 + cell count was Ͼ20/ l, beginning on average on day +13 after the end of priming CHT (range [11][12][13][14][15][16][17][18]. Aphereses were carried out using an automated blood cell separator Fenwall CS 3000 Plus (Baxter, Deerfield, IL, USA), with a 50 ml/min flow rate, according to modified program 1 for lymphocyto-apheresis; as previously described the total volume processed ranged from 7 to 11 liters (median 10) and a final volume of 50 ml was collected using the Baxter small volume chamber.…”

Section: Patientsmentioning

confidence: 99%

“…14 Before transplantation and between day +30 and +60, patients were evaluated for cardiac function (left ventricular ejection fraction, LVEF) using echocardiography or radionuclide ventriculography, respiratory function evaluating respiratory volumes (flow expiratory volume 1 (FEV1), flow volume capacity (FVC) and the FEV1/FVC ratio) and COLD (CO lung diffusion), [15][16][17] immune reconstitution, and bone marrow examination.…”

Section: Patient Care and Quality Of Life Evaluationmentioning

confidence: 99%

“…Median duration of neutropenia (ANC Ͻ0.1 ϫ 10 9 /l) was 6 days (range: 2-18); the ANC remained below 0.5 ϫ 10 9 /l for a median time of 8 days (range: [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] in all transplant procedures.…”

Section: Hematological Toxicity and Engraftment Kineticsmentioning

confidence: 99%

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Very low toxicity and good quality of life in 48 elderly patients autotransplanted for hematological malignancies: a single center experience

Olivieri

Capelli

Montanari

et al. 2001

Bone Marrow Transplant

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Summary:Between May 1994 and May 2000, we autotransplanted 48 consecutive patients, 21 females and 27 males aged over 60 years (range: 60-78, median: 63). Sixteen patients had multiple myeloma (MM), 14 high-grade non-Hodgkin's lymphoma (HGNHL), six low-grade non-Hodgkin's lymphoma (LGNHL), nine acute myeloid leukemia (AML), one chronic lymphocytic leukemia (CLL), one Hodgkin's disease (HD) and one breast cancer; the performance status (WHO) was 0-1. Seventeen patients were in 1st CR (35.4%) and one in 2nd CR (2.1%), 25 in PR (52.1%), while five patients had been transplanted with progressive disease (10.4%); seven patients with MM received a double transplant. Patients received high-dose therapy including melphalan alone (13) or associated with other drugs (26), busulfan-cyclophosphamide (three), BEAM (11) and TBI (two). All patients took a median of 11 (range: 8-25) days to reach neutrophils Ͼ500/ l, 13 (range: 9-83) days to reach platelets Ͼ20 000/ l and 17 (range: 11-83) days to reach platelets Ͼ50 000/ l. Hematological toxicity, hospital stay and supportive care did not differ from those of a cohort of younger patients. At present, 31 patients are alive (14 in CR, five in PR, five in PD and seven in relapse) and 16 died from PD at a median follow-up of 37 months (1-67). Only one patient died from transplant-related toxicity. Quality of life, evaluated using a QLQ-C30 questionnaire in 25 patients at day +90, was good. In our experience PBPC mobilization and transplantation is feasible in patients aged у60 years and the toxicity of this procedure is acceptable, with an early transplant-related mortality of 1.8%; therefore patients with hematological malignancies potentially curable with high-dose therapy (HDT) should also be candidates for HDT. Bone Marrow Transplantation (2001) 4 HDT with ASCT has also been proven to cure or prolong survival after failure of primary CHT.Finally, in ANLL and in many chemosensitive solid tumors, HDT with ASCT has proved to be at least as good as the best chemotherapy (CHT). 5,6 Extrahematological toxicity, performance status and age represent the main hurdles in using HDT in elderly patients. To date, very few reports concerning the use of HDT in elderly patients have been published 7-9 and ASCT is usually restricted in many centers to patients aged less than 50 or 60 years. An EBMT survey reports transplant-related mortality 13% (TRM) in patients aged 55 years and over, transplanted for intermediate-high grade NHL, 10 but more recent data suggest that in the same setting, very low TRM can be achieved, using mobilized PBSC and conditioning regimens not including TBI. [7][8][9] Here, we report our single center experience in 48 patients aged Ͼ60 years (33% of these aged Ͼ65 years), autotransplanted with PBSC for hematological malignancies. Patients and methods PatientsBetween May 1994 and May 2000, we transplanted 48 patients aged more than 60 years (range 60-78 years; median 63 years), 21 females and 27 males. Patients were eligible for HDT when performance status (PS WHO sc...

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Section: Patientsmentioning

confidence: 99%

Section: Patient Care and Quality Of Life Evaluationmentioning

confidence: 99%

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Very low toxicity and good quality of life in 48 elderly patients autotransplanted for hematological malignancies: a single center experience

Olivieri

Capelli

Montanari

et al. 2001

Bone Marrow Transplant

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“…There are no exact data on prognosis for liver transplantation in patients with CCMP. Data from the past showed that CCMP worsens in the early period after liver transplantation, and later cardiac functions and cardiac electromechanical dysfunctions improve gradually by supplying hemodynamic stabilization of the patient [10,[59][60][61][62][63][64]. Liver transplantation can be a definitive treatment for CCMP.…”

Section: Treatmentmentioning

confidence: 99%

Cirrhotic Cardiomyopathy

Çeltik¹,

Gerenli²,

Emiroğlu³

et al. 2017

Cardiomyopathies - Types and Treatments

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Cirrhotic cardiomyopathy (CCMP) is a functional disorder characterized by electrophysiologic disturbances and diastolic and/or systolic dysfunction in patients with chronic liver disease, especially those with ascites and portal hypertension. This disorder is a well-defined entity in adults, but pediatric data are limited. Clinical and laboratory findings are generally latent. The diagnostic criteria are prolonged QT on electrocardiography due to metabolic and extrahepatic causes, in addition to some abnormal echocardiography findings. If echocardiographic findings are normal and only specific prolonged QT is present, this disorder is named as "latent CCMP"; otherwise, it is "manifest CCMP." This disorder is important because it may lead to problems such as cardiac failure and dysrhythmia before or after liver transplantation. Moreover, it may worsen the prognosis.

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“…14,15 However, the main finding of this study apparently contradicts an earlier Spanish study. The only previous description of cardiac function pretransplantation and posttransplantation was reported by Acosta and colleagues 16 from Murcia. These authors performed baseline pre-transplantation echocardiography, then repeated these measurements a mean of 21 months after transplantation (range, 13-40 months) in 30 patients.…”

mentioning

confidence: 99%

What Happens to Cirrhotic Cardiomyopathy After Liver Transplantation? *

Liu

Lee

2005

Hepatology

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BACKGROUND/AIMS: Liver cirrhosis induces cardiac alterations. We aimed to define these alterations and assess their reversibility after transplantation. METHODS: Cirrhotic patients (n‫)04؍‬ and controls (n‫)51؍‬ underwent echocardiography and stress ventriculography. Fifteen cirrhotics were reevaluated 6-12 months after transplantation. RESULTS: Cirrhotics had higher left ventricular wall thickness (9.6 ؎ 1.2 vs. 8.8 ؎ 1.2mm; p< 0.05) and ejection fraction (73 ؎ 6 vs. 65 ؎ 4%, p < 0.001) than controls. Basal diastolic function was similar. During stress, patients with cirrhosis presented lower increases of heart rate, left ventricular ejection fraction, stroke volume and cardiac index (p < 0.05 for all), and diastolic dysfunction with lower ventricular peak filling rate (p ‫؍‬ 0.001). Exercise capacity was reduced (48 ؎ 21 vs. 76 ؎ 24W; p < 0.001). Ascitic patients exhibited more diastolic dysfunction at rest and during stress compared with non-ascitic patients. Liver transplantation caused regression of ventricular wall thickness (10.2 ؎ 1.3 vs. 9.5 ؎ 1.2mm; p < 0.05), improvement of diastolic function, and normalization of systolic response and exercise capacity during stress (significant increases in heart rate, ventricular ejection fraction, stroke volume, and cardiac index; p < 0.05 for all). CONCLUSIONS: Cardiac alterations in cirrhosis present with mild increases in ventricular wall thickness, diastolic dysfunction that worsens with ascites and physical stress, and abnormal systolic response to stress limiting exercise capacity. Liver transplantation reverses these alterations.

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Evaluation of cardiac function before and after liver transplantation

Cited by 24 publications

References 5 publications

Very low toxicity and good quality of life in 48 elderly patients autotransplanted for hematological malignancies: a single center experience

Very low toxicity and good quality of life in 48 elderly patients autotransplanted for hematological malignancies: a single center experience

Cirrhotic Cardiomyopathy

What Happens to Cirrhotic Cardiomyopathy After Liver Transplantation? *

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