Incidence, predictors and outcomes of new onset systolic heart failure following orthotopic liver transplant: A systematic review

Authors

Amrin Kharawala, Department of Medicine, Jacobi Medical Center, Bronx, NY, USA; Albert Einstein College of Medicine, Bronx, NY, USA; New York City Health and Hospitals Corporation, NYC, USA.
Israel Safiriyu, Department of Medicine, Jacobi Medical Center, Bronx, NY, USA; Albert Einstein College of Medicine, Bronx, NY, USA; New York City Health and Hospitals Corporation, NYC, USA.
Adebolu Olayinka, Department of Medicine, Cleveland Clinic Akron General Medical Center, Akron, OH, USA.
Adrija Hajra, Montefiore Medical Center, Bronx, NY, USA.
Jiyoung Seo, Department of Medicine, Jacobi Medical Center, Bronx, NY, USA; Albert Einstein College of Medicine, Bronx, NY, USA; New York City Health and Hospitals Corporation, NYC, USA.
Harriet Akunor, Department of Medicine, Jacobi Medical Center, Bronx, NY, USA; Albert Einstein College of Medicine, Bronx, NY, USA; New York City Health and Hospitals Corporation, NYC, USA.
Majd Al Alhuarrat, Department of Medicine, Jacobi Medical Center, Bronx, NY, USA; Albert Einstein College of Medicine, Bronx, NY, USA; New York City Health and Hospitals Corporation, NYC, USA.
Rosy Thachil, Division of Cardiology, Elmhurst Hospital Center, Queens, USA; Mount Sinai School of Medicine, Queens, USA; New York City Health and Hospitals Corporation, NYC, USA. Electronic address: thachilr@nychhc.org.

Document Type

Article

Publication Title

Transplantation reviews (Orlando, Fla.)

Abstract

BACKGROUND: New onset Systolic heart failure (SHF), characterized by new onset left ventricular (LV) systolic dysfunction with a reduction in ejection fraction (EF) of <40%, is a common cause of morbidity and mortality among Orthotopic liver transplant (OLT) recipients. Therefore, we aimed to evaluate the prevalence, the pre-transplant predictors, and the prognostic impact of SHF post-OLT. METHODS: We conducted a systematic review of the literature using electronic databases MEDLINE, Web of Science, and Embase for studies reporting acute systolic heart failure post-liver transplant from inception to August 2021. RESULT: Of 2604 studies, 13 met the inclusion criteria and were included in the final systematic review. The incidence of new-onset SHF post OLT ranged from 1.2% to 14%. Race, sex, or body mass index did not significantly impact the post-OLT SHF incidence. Alcoholic liver cirrhosis, pre-transplant systolic or diastolic dysfunction, troponin, brain natriuretic peptide (BNP), blood urea nitrogen (BUN) elevation, and hyponatremia were noted to be significantly associated with the development of SHF post-OLT. The significance of MELD score in the development of post-OLT SHF is controversial. Pre-transplant beta-blocker and post-transplant tacrolimus use were associated with a lower risk of developing SHF. The average 1-year mortality rate in patients with SHF post-OLT ranged from 0.00% to 35.2%. CONCLUSION: Despite low incidence, SHF post-OLT can lead to higher mortality. Further studies are required to fully understand the underlying mechanism and risk factors.

First Page

100758

DOI

10.1016/j.trre.2023.100758

Publication Date

4-1-2023

Recommended Citation

Kharawala, Amrin; Safiriyu, Israel; Olayinka, Adebolu; Hajra, Adrija; Seo, Jiyoung; Akunor, Harriet; Alhuarrat, Majd Al; and Thachil, Rosy, "Incidence, predictors and outcomes of new onset systolic heart failure following orthotopic liver transplant: A systematic review" (2023). Systematic Reviews. 19.
https://scholar.bridgeporthospital.org/descriptive_study/19

Identifier

37027999 (pubmed); 10.1016/j.trre.2023.100758 (doi); S0955-470X(23)00012-5 (pii)