Abstract:
BACKGROUND:As the indications for liver transplantation broaden to include older and more critically ill patients, the likelihood of encountering unsuspected cardiovascular disease increases. PURPOSE:This study examined the frequency, type, and subsequent outcome of intra- and postoperative cardiovascular complications that occurred during the first 6 months following liver transplantation. METHODS:The records of 146 consecutive patients who underwent primary liver transplantation were reviewed retrospectively to determine the occurrence of major (myocardial infarction or reversible ischemia, pulmonary edema, cardiogenic shock, symptomatic rhythm disturbances, or pulmonary embolism) and minor (transient hypertension, hypotension, atrial or ventricular premature beats) cardiac events. The relation between such events and actuarial patient survival was evaluated. Stepwise logistic regression analysis was also employed to identify those pre-operative variables that predicted an increased risk of postoperative events or mortality. RESULTS:Cardiac events directly caused or contributed to 4 deaths (2.7%). Ventricular tachycardia/fibrillation was the most frequent intra-operative cardiac complication (3.4%); transient hypotension (post-reperfusion syndrome) was the most common minor event (20%). Thirty-four recipients (23%) developed a major postoperative cardiac complication including pulmonary edema (9%), myocardial ischemia or infarction (5.4%), new dilated cardiomyopathy (3.4%), and ventricular tachycardia (2.7%). Pre-existing cardiac disease and older age (mean age 49 +/- 8 years) at transplantation were the only independent predictors of a major complication. Major cardiac events did not affect 6 month survival but were associated with a lower 5-year survival rate (event: 32% vs event-free: 52%; p = 0.04). The frequency of major intraoperative (21% vs 2%; p = 0.0005) and postoperative (57% vs 17%; p = 0.0001) cardiac complications was significantly higher for recipients with known heart disease (Group A) compared with those without pre-existing heart disease (Group B). Five-year survival in Group A patients was 36% versus 50% for Group B patients; p = 0.45. CONCLUSION:One or more cardiovascular complications occurred in over 70% of liver transplant recipients. Major events were associated with a lower likelihood of long-term survival. Older patients, particularly those with pre-existing but compensated heart disease, are at greatest risk for a major cardiac event and may require more extensive pre-operative risk assessment.
journal_name
Clin Transplantjournal_title
Clinical transplantationauthors
Dec GW,Kondo N,Farrell ML,Dienstag J,Cosimi AB,Semigran MJsubject
Has Abstractpub_date
1995-12-01 00:00:00pages
463-71issue
6eissn
0902-0063issn
1399-0012journal_volume
9pub_type
杂志文章abstract:BACKGROUND:After pancreas transplantation (PTx) some patients report occasional symptoms of hypoglycaemia and at times, serious hypoglycaemia. Continuous blood glucose monitoring (CBGM) allows determination of the daily glucose profile and detection of unrecognized hypoglycaemia. The aims of our study were to determine...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1046/j.1399-0012.2003.00101.x
更新日期:2003-12-01 00:00:00
abstract::Measurement of indocyanine green plasma disappearance rate (PDR(ICG)) has been suggested as a meaningful liver function parameter. However, there are only very limited data concerning its value in the monitoring of graft dysfunction (GDF) and primary non-function (PNF) especially during molecular absorbent recirculati...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2007.00706.x
更新日期:2007-11-01 00:00:00
abstract::Hepatitis C virus (HCV) is currently the leading indication worldwide for orthotopic liver transplantation. However, the majority of patients receiving transplant for HCV eventually develop histopathologic evidence of recurrent allograft HCV and approximately 10% die or require retransplantation within the first 5 pos...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-0012.2003.00049.x
更新日期:2003-06-01 00:00:00
abstract:INTRODUCTION:Aortoiliac pathology in kidney allograft recipients is not rare but treatment timing is controversial. As most publications on this topic are case reports its difficult to evaluate long-term outcomes of those clinical challenges. Herein we report long-term results of these procedures. METHODS:From 1970 to...
journal_title:Clinical transplantation
pub_type: 临床试验,杂志文章
doi:10.1111/j.1399-0012.2009.00981.x
更新日期:2009-03-01 00:00:00
abstract::Xenotransplantation is a potential strategy to overcome the shortage of human donor organs. As this technique has a major medical and psychological impact on patients and their family and friends, the attitude of patients currently waiting for organ transplantation is important. Therefore, we conducted a survey on the...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2010.01296.x
更新日期:2011-05-01 00:00:00
abstract:BACKGROUND:Progressive familial intrahepatic cholestasis (PFIC) results in liver cirrhosis. Therefore, some PFIC patients require liver transplantation (LT). Although three types of PFIC have been identified, their etiologies include unknown mechanisms. PATIENTS:A total of 717 recipients who underwent living-donor LT ...
journal_title:Clinical transplantation
pub_type: 临床试验,杂志文章
doi:10.1111/j.1399-0012.2010.01368.x
更新日期:2011-09-01 00:00:00
abstract:BACKGROUND:The accurate estimation of liver volume and right/left ratio in donor candidates is critical, but there is no method using portal vein (PV) flow. METHODS:Of 125 donor candidates, right/left liver volume ratio was estimated using ultrasound (US)-PV area ratio and Doppler US-PV flow ratio, and the results wer...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13050
更新日期:2017-09-01 00:00:00
abstract::Hepatic allograft rejection still remains an important problem following liver transplantation. Early acute rejection, occurring within three months of transplant, is a common event and usually of lesser significance with respect to prognosis than other non-immune-related post-transplant morbidities. However, little i...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2007.00788.x
更新日期:2008-05-01 00:00:00
abstract::In the general population, obesity is associated with an increased risk of developing hypertension (HTN), type 2 diabetes mellitus (DM), and end-stage renal disease (ESRD). Therefore, most transplant centers have a body mass index (BMI) threshold for accepting living kidney donors. But there have been no studies of po...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13360
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND:The Southeastern Kidney Transplant Coalition was created in 2010 to improve kidney transplant (KTx) rates in Georgia, North Carolina, and South Carolina. To identify dialysis staff-reported barriers to transplant, the Coalition developed a survey of dialysis providers in the region. METHODS:All dialysis uni...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12693
更新日期:2016-04-01 00:00:00
abstract::Whether extracorporeal membrane oxygenation (ECMO) as a bridge to lung transplantation (BTT) can achieve a similar survival to non-BTT remains controversial. We conducted this meta-analysis to compare the outcomes between ECMO BTT and non-BTT to facilitate better clinical decision-making. Seven databases were searched...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.14157
更新日期:2020-11-22 00:00:00
abstract::Bone mineral density (BMD) in the lumbar spine and femoral neck, the incidence of osteoporosis, and survival up to 10 years after heart transplantation (HT) were investigated in 169 patients who underwent HT at Skåne University Hospital in Lund, Sweden, 1988-2016. Within the first year post-transplantation, mean (SD) ...
journal_title:Clinical transplantation
pub_type: 临床试验,杂志文章
doi:10.1111/ctr.13477
更新日期:2019-03-01 00:00:00
abstract:BACKGROUND:Cardiovascular disease is the leading cause of morbidity and mortality in patients with chronic kidney disease (CKD). In fact, death from cardiovascular disease is the number one cause of graft loss in kidney transplant (KTx) patients. Compared to patients on dialysis, CKD patients with KTx have increased qu...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12816
更新日期:2016-10-01 00:00:00
abstract::With increasing shortage of donor organs and changes in organ allocation systems, there is a considerable need for alternative or supportive techniques in the field of liver transplantation. Liver cell transplantation (LCT) is such an innovative technique that is especially promising for use in children, because it is...
journal_title:Clinical transplantation
pub_type: 杂志文章,评审
doi:10.1111/j.1399-0012.2009.01113.x
更新日期:2009-12-01 00:00:00
abstract::Although risk factors for failure of renal retransplants have been well studied, the impact of allograft nephrectomy on subsequent renal transplantation in the cyclosporin era is not well defined. The purpose of this study is to define the effect of nephrectomy of the primary allograft on subsequent allograft survival...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1996-04-01 00:00:00
abstract:BACKGROUND:It is unclear whether sirolimus, a newer immunosuppressive agent, widely used in renal transplantation, affects male sex hormone levels or sexual function. METHODS:Sex hormone profiles in male renal transplant recipients were obtained and compared between a sirolimus-treated group and a group not on sirolim...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2005.00257.x
更新日期:2005-04-01 00:00:00
abstract:AIM:Uncontrolled donation after cardiac death (uDCD) remains an underutilized source of kidney allografts in the United States. The objective of this study was to estimate the impact of the implementation of a uDCD program on transplantation rates and long-term survival for patients with end-stage renal disease (ESRD) ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13868
更新日期:2020-07-01 00:00:00
abstract::Use of C(2) monitoring for cyclosporine A (CsA) microemulsion results in improved clinical outcomes vs. trough (C(0)) monitoring. Logistical issues include accurate timing of the C(2) sample; requirement for sample dilution with most standard assay techniques; and inconvenience for patients. Recently, it has been show...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2005.00472.x
更新日期:2006-03-01 00:00:00
abstract::The current pandemic SARS-CoV-2 has required an unusual allocation of resources that can negatively impact chronically ill patients and high-complexity procedures. Across the European Reference Network on Pediatric Transplantation (ERN TransplantChild), we conducted a survey to investigate the impact of the COVID-19 o...
journal_title:Clinical transplantation
pub_type: 杂志文章,多中心研究
doi:10.1111/ctr.14063
更新日期:2020-10-01 00:00:00
abstract:INTRODUCTION:Health-related quality of life (HRQOL) is severely impaired in advanced liver disease. The purpose of this study was to evaluate the impact of actual liver function and disease-specific factors on HRQOL of patients evaluated for liver transplantation. PATIENTS AND METHODS:Disease-specific QOL was analyzed...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12426
更新日期:2014-12-01 00:00:00
abstract::The stress, coping resources, and family functioning of 36 mothers of children awaiting transplantation were evaluated. Using standardized assessment techniques, we found that, overall, 20% of mothers reported clinically elevated stress responses and that parenting stress was higher for mothers of children evaluated f...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1996-10-01 00:00:00
abstract:BACKGROUND:The survival of patients returning to hemodialysis (HD) following kidney transplant failure is unfavorable. However, the factors responsible for this poor outcome are largely unknown; chronic inflammation due to failed allograft and malnutrition may contribute to morbidity and mortality. We aimed to compare ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2009.01097.x
更新日期:2010-07-01 00:00:00
abstract:BACKGROUND:Cyclosporine (CsA) and tacrolimus (Tac) in heart transplantation (HTx) have been compared but with certain drawbacks. We compared both drugs in a prospective analysis with medium-term follow-up. METHODS:Hundred and six patients were randomized to receive CsA or Tac (53 per group). Target levels of CsA were ...
journal_title:Clinical transplantation
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1399-0012.2010.01309.x
更新日期:2011-07-01 00:00:00
abstract::Kidney transplantation offers longer survival, less morbidity and lower costs than dialysis. It is also believed to improve quality of life. The aim of this study was to compare prospectively the perceived health status (PHS) of dialyzed patients on a waiting list with kidney transplant recipients after transplantatio...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2009.01080.x
更新日期:2010-05-01 00:00:00
abstract:OBJECTIVE:The objective of this retrospective study was to characterize the neutrophil to lymphocyte ratio (NLR) on the waitlist and determine its prognostic utility in liver transplantation (LT) for hepatocellular carcinoma (HCC) with special focus on longitudinal data. Biomarkers such as pre-operative NLR have been s...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13743
更新日期:2019-12-01 00:00:00
abstract::We examined histological features of allograft biopsies in ABO minor-mismatched kidney transplantation. Forty-five patients who underwent ABO minor-mismatched kidney transplantation between September 1999 and December 2001 at our institute. The mean age was 32.6 years, with 28 males and 17 females. We divided them int...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-0012.17.s10.1.x
更新日期:2003-01-01 00:00:00
abstract::Stroke incidence is high in end-stage renal disease, and risk factors differ between the dialysis and general populations. However, risk factors and outcomes following renal transplantation remain unclear. We analyzed all adult patients with a functioning renal transplant from 01/01/2007 to 12/31/2012. Data were extra...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12765
更新日期:2016-08-01 00:00:00
abstract::The effect of HLA-DR3 gene expression was studied in black cadaveric renal allograft recipients of organs from the same donor race. From January 1984 to June 1992, 70 patients received cadaveric renal allografts at the Medical University of Southern Africa (MEDUNSA). The average age and F:M ratio was 30 years and 1: 1...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1996-02-01 00:00:00
abstract:BACKGROUND:Liver transplantation with livers grafts from elderly donors has been associated with a higher risk of biliary complications. The aim of this study was to examine whether our national protocol could contribute to a lower incidence of biliary complications. METHODS:All adult recipients in the Netherlands tra...
journal_title:Clinical transplantation
pub_type: 杂志文章,多中心研究
doi:10.1111/ctr.12569
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND:The therapeutic drug monitoring of mycophenolic acid (MPA) has been investigated for renal and heart transplantations; however, its usefulness in lung transplantation is unclear. METHODS:The MPA area under the plasma concentration-time curve (AUC) was calculated in 59 adult lung transplant recipients. The M...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.14088
更新日期:2020-12-01 00:00:00