Prediction of Cardiac Complications After Liver Transplantation

Fouad, Tamer; Abdel-Razek, Waël; Burak, Kelly W.; Bain, Vincent G.; Lee, Samuel S.

doi:10.1097/tp.0b013e318198d734

Cited by 132 publications

(91 citation statements)

References 52 publications

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“…Pulmonary edema was the most common complication, occurring in 61 patients; other complications included heart failure (7 patients), arrhythmia (13 patients), pulmonary hypertension (7 patients), pericardial effusion (2 patients), and cardiac thrombus formation (1 patient). In their study, cardiac causes were the leading cause of death (23.8% of all mortality) [81].…”

Section: Discussionmentioning

confidence: 99%

Cirrhotic Ascites: Pathophysiological Changes and Clinical Implications

Bendahmash¹,

Elsiesy²,

Hamoudi³

2017

Ascites - Physiopathology, Treatment, Complications and Prognosis

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Liver cirrhosis is associated with a wide range of systemic and pulmonary vascular abnormalities. Cardiac dysfunction also occurs in patients with advanced liver disease (cirrhotic cardiomyopathy). The circulation in cirrhosis is hyperdynamic, which is typically characterized by hypotension resulting from the associated vasodilatation and reflex tachycardia. The circulatory dysfunction in cirrhosis is the proposed pathophysiological mechanism leading to sodium and water retention in patients with liver cirrhosis. Hyperdynamic circulation is triggered by increased intrahepatic resistance due to cirrhosis, leading to a progressive increase in portal venous pressure. As portal hypertension worsens, local production of vasodilators increases due to endothelial activation, leading to splanchnic and systemic arterial vasodilation. Nitric oxide (NO) is considered one of the most important vasodilator molecules in the splanchnic and systemic circulation. The reduction in the effective arterial blood volume results in diminished renal arterial blood flow and subsequently triggers the rennin-angiotensin-aldosterone system (RAAS), antidiuretic hormones (ADHs) and sympathetic nervous system (SNS), leading to renal artery vasoconstriction. All these changes lead to sodium retention and volume expansion, manifested as ascites and peripheral edema. Furthermore, disease progression is associated with various degrees of renal dysfunction.

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Section: Discussionmentioning

confidence: 99%

Cirrhotic Ascites: Pathophysiological Changes and Clinical Implications

Bendahmash¹,

Elsiesy²,

Hamoudi³

2017

Ascites - Physiopathology, Treatment, Complications and Prognosis

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“…8 Systolic dysfunction in patients with cirrhosis is diagnosed as the inability of the heart to increase ejection fraction under stress. 4 Systolic dysfunction is associated with a high incidence of pulmonary edema (18%) after LT. 9 Diastolic dysfunction is more severe in patients with ascites. It is important to diagnose diastolic dysfunction because it may result in acute heart failure and pulmonary edema after LT and transjugular intrahepatic portosystemic shunt, thus contributing to high morbidity and mortality.…”

Section: Introductionmentioning

confidence: 99%

Untitled

Müderrisoğlu

Yılmaz

Karaçağlar

et al. 2017

Exp Clin Transplant

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“…However, after the introduction of the MELD score as a criterion for prioritization in the transplant waiting list, more severe patients and those with more comorbidities were prioritized for indication and performance of surgery 105,106 . Also, the indication for transplantation in patients older than 50 years has been increasingly frequent [107][108][109] , and with increasing life expectancy, these patients tend to develop or complicate coronary artery disease more often than the population the same age and sex 108,110,111 .…”

Section: Livermentioning

confidence: 99%