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

World Journal of Hepatology 2022年第7期14卷 1398-1407页

作者： Michael Delicce Joseph Mauch Abel Joseph Ruishen Lyu Heather Kren Rose Bartow donna ferchill Maan Fares Jamile Wakim-Fleming Department of Internal Medicine Cleveland ClinicClevelandOH 44195United States Lerner College of Medicine at Case Western Reserve University Cleveland ClinicClevelandOH 44195United States Department of Quantitative Health Sciences Cleveland ClinicClevelandOH 44195United States Department of Liver Transplantation Cleveland ClinicClevelandOH 44195United States Department of Cardiovascular Medicine Cleveland ClinicClevelandOH 44195United States Department of Gastroenterology Hepatology and NutritionCleveland ClinicClevelandOH 44195United States

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

关键词： Nonalcoholic fatty liver disease Liver transplant Cardiovascular disease Pre-transplant outcomes Coronary artery disease Risk factors

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