Cardiovascular Complications Following Living Donor Liver Transplantation

Abstract

The current work was designed to study the cardiovascular events after living donor liver transplantation ( LDLT) and to identify the risk factors associated with these complications . To fulfill such purpose, we studied (155) patients who underwent liver transplantation from 2013 to 2015 at Ain Shams center of organ transplantation (ASCOT). All patients were subjected to detailed history taking, clinical examination,ECG, radiological assessment with Trans-thoracic Echocardiography,Echo Doppler ,Dobutamine stress Echo or treadmill test. laboratory investigations including: liver profile tests, kidney function tests, complete blood picture, prothrombin time &serum Na and K. In the current study, a hundred and thirty six patients (87.7%) were males and nineteen patients (12.3%) were females. Mean age of the studied patients & the mean age at the time of LT was 46.9 years & the median age was 52.0 years. In the current study we found that The prevalence of post operative cardiac complications of patients with liver transplantation was 23.2% with 95% Confidence interval of post operative cardiac complications (16.8 - 30.6) . Also, the higher post operative complications were found among older patients As regards the ECG abnormalities we found thatThere was a higher mean age among cases with abnormal ECG compared to cases with normal ECG and the difference was highly significant statistically. Also, we found that the higher percentage of abnormal ECG among females compared to males but the difference is not significant statistically.

Regarding the occurrence of post operative cardiac complications of patients with liver transplantation was 23.2% with 95% Confidence interval of post operative cardiac complications (16.8 - 30.6) . In the current study 22.6% of the patients developed hypertension after transplantation, 7.1% of the patients had IHD and 6.5% of the patients developed both complications. Which means that hypertension is the most frequent cardiovascular complication following liver transplantation. Also, There was higher percentage of cardiac complications among males 23.5% compared to females 21.1% and the difference was not significant statistically Regarding the association of the ECG abnormality and post operative cardiovascular complications There was higher percentage of cardiac complications among cases with abnormal ECG 54.5% compared to 20.8% among cases with no ECG abnormality and the difference was significant statistically. Cases with ECG abnormality had 4 times risk of developing cardiac complications compared to cases with normal ECG. In the current study, regarding the Echocardiography findings There was higher mean ejection fraction (EF) and Left atrial diameter ( LAD) among cases with cardiac complications but the difference was not significant statistically.