Acute heart failure after Orthotopic liver transplantation: A case series from one center

Sonal Sharma, Kunal Karamchandani, Ryan Wilson, Sean Baskin, Dmitri Bezinover

Research output: Contribution to journalArticle

Abstract

Background: Patients undergoing liver transplantation (LT) can develop acute heart failure (HF) in the postoperative period despite having had a normal cardiac evaluation prior to surgery. End-stage liver disease is often associated with underlying cardiac dysfunction which, while not identified during preoperative testing, manifests itself during or immediately after surgery. Case presentation: We describe three cases of non-ischemic acute HF developing shortly after LT in patients who had a normal preoperative cardiac evaluation. The challenges associated with both diagnosis and management of acute HF in the setting of a newly implanted graft will be discussed. Conclusions: Diastolic dysfunction, QTc interval prolongation, and an increase in BNP may be predictive of postoperative HF. Current recommendations for preoperative cardiovascular evaluation of transplant candidates does not include studies examining these risk factors and should be revised. Further investigations are necessary to evaluate these findings.

Original languageEnglish (US)
Article number102
JournalBMC Anesthesiology
Volume18
Issue number1
DOIs
StatePublished - Jul 31 2018

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Liver Transplantation
Heart Failure
Transplants
End Stage Liver Disease
Postoperative Period

All Science Journal Classification (ASJC) codes

  • Anesthesiology and Pain Medicine

Cite this

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Acute heart failure after Orthotopic liver transplantation : A case series from one center. / Sharma, Sonal; Karamchandani, Kunal; Wilson, Ryan; Baskin, Sean; Bezinover, Dmitri.

In: BMC Anesthesiology, Vol. 18, No. 1, 102, 31.07.2018.

Research output: Contribution to journalArticle

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AU - Sharma, Sonal

AU - Karamchandani, Kunal

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AU - Bezinover, Dmitri

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AB - Background: Patients undergoing liver transplantation (LT) can develop acute heart failure (HF) in the postoperative period despite having had a normal cardiac evaluation prior to surgery. End-stage liver disease is often associated with underlying cardiac dysfunction which, while not identified during preoperative testing, manifests itself during or immediately after surgery. Case presentation: We describe three cases of non-ischemic acute HF developing shortly after LT in patients who had a normal preoperative cardiac evaluation. The challenges associated with both diagnosis and management of acute HF in the setting of a newly implanted graft will be discussed. Conclusions: Diastolic dysfunction, QTc interval prolongation, and an increase in BNP may be predictive of postoperative HF. Current recommendations for preoperative cardiovascular evaluation of transplant candidates does not include studies examining these risk factors and should be revised. Further investigations are necessary to evaluate these findings.

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