Cardiac risk factors limiting survival to liver transplantation in patients with nonalcoholic fatty liver disease

作     者：Michael Delicce Joseph Mauch Abel Joseph Ruishen Lyu Heather Kren Rose Bartow Donna Ferchill Maan Fares Jamile Wakim-Fleming 

作者机构：Department of Internal MedicineCleveland ClinicClevelandOH 44195United States Lerner College of Medicine at Case Western Reserve UniversityCleveland ClinicClevelandOH 44195United States Department of Quantitative Health SciencesCleveland ClinicClevelandOH 44195United States Department of Liver TransplantationCleveland ClinicClevelandOH 44195United States Department of Cardiovascular MedicineCleveland ClinicClevelandOH 44195United States Department of GastroenterologyHepatology and NutritionCleveland ClinicClevelandOH 44195United States 

出 版 物：《World Journal of Hepatology》 (世界肝病学杂志（英文版）（电子版）)

年 卷 期：2022年第14卷第7期

页      面：1398-1407页

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：Nonalcoholic fatty liver disease Liver transplant Cardiovascular disease Pre-transplant outcomes Coronary artery disease Risk factors 

摘      要：BACKGROUND Nonalcoholic fatty liver disease(NAFLD)describes the hepatic manifestations of metabolic syndrome,which is estimated to affect 25%of adults,and currently represents the second most common indication for liver transplant in the United *** have shown that patients with NAFLD are at an increased risk for heart failure,arrhythmia,and coronary artery disease(CAD),which may impact outcomes of liver ***,it remains unclear whether the presence of cardiac disease affects survival prior to liver *** so,this would represent an important opportunity to optimize cardiac status and improve outcomes before liver *** To identify cardiac factors that impact survival to liver transplantation in patients with NAFLD and on the transplant *** The aim of this study was to identify cardiac risk factors that limit survival to transplant in patients with *** performed a retrospective analysis of patients with NAFLD listed for liver transplant at a tertiary academic medical center in the United States from January 2015 to January 2021,identified through United Network of Organ Sharing *** criteria included a concurrent etiology of liver disease and removal from the transplant list due to chemical dependency,lack of social support,improvement in liver disease,or being lost to *** manually reviewed patient charts including electrocardiogram,echocardiogram,and cardiac catheterization reports as well as physician notes to identify cardiac disease states(i.e.,heart failure,arrhythmia,valvular disease and CAD)and other related *** performed a survival analysis by Cox proportional hazards regression model to analyze the association between cardiac factors at the time listed for transplant and death or clinical deterioration prior to *** Between January 2015 and January 2021,265 patients with nonalcoholic fatty liver disease were listed for liver transplant at our instituti