The role of echocardiographic assessment for the risk of adverse events in liver transplant recipients: A systematic review and meta-analysis.

E/A ratio E/e’ Left ventricular diastolic dysfunction Left ventricular ejection fraction Tricuspid regurgitation

Journal

Transplantation reviews (Orlando, Fla.)
ISSN: 1557-9816
Titre abrégé: Transplant Rev (Orlando)
Pays: United States
ID NLM: 8804364

Informations de publication

Date de publication:
22 Feb 2024
Historique:
received: 17 01 2024
revised: 16 02 2024
accepted: 19 02 2024
medline: 29 2 2024
pubmed: 29 2 2024
entrez: 28 2 2024
Statut: aheadofprint

Résumé

Echocardiographic findings may provide valuable information about the cardiac conditions in cirrhotic patients waiting for liver transplantation (LT). However, data on the ability of the different echocardiographic parameters to predict post-transplant risk of mortality are scarce and heterogeneous. This systematic review evaluates the role of different echocardiographic features as predictors of post-LT mortality. A meta-analysis was also performed according to the observed results. A systematic review was conducted according to PRISMA guidelines. Medline (PubMed) database was searched through February 2023 for relevant published original articles reporting the prognostic value of echocardiographic findings associated with outcomes of adult LT recipients. The risk of bias in included articles was assessed using ROBINS-E tool. Methodological quality varied from low to high across the risk of bias domains. Twenty-three studies were identified after the selection process; ten were enrollable for the meta-analyses. According to the results observed, the E/A ratio fashioned as a continuous value (HR = 0.43, 95%CI = 0.25-0.76; P = 0.003), and tricuspid regurgitation (HR = 2.36, 95%CI = 1.05-5.31; P = 0.04) were relevant predicting variables for post-LT death. Other echocardiographic findings failed to merge with statistical relevance. Tricuspid regurgitation and left ventricular diastolic dysfunction play a role in the prediction of post-LT death. More studies are needed to clarify further the impact of these echocardiographic features in the transplantation setting.

Sections du résumé

BACKGROUND & AIMS OBJECTIVE
Echocardiographic findings may provide valuable information about the cardiac conditions in cirrhotic patients waiting for liver transplantation (LT). However, data on the ability of the different echocardiographic parameters to predict post-transplant risk of mortality are scarce and heterogeneous. This systematic review evaluates the role of different echocardiographic features as predictors of post-LT mortality. A meta-analysis was also performed according to the observed results.
METHODS METHODS
A systematic review was conducted according to PRISMA guidelines. Medline (PubMed) database was searched through February 2023 for relevant published original articles reporting the prognostic value of echocardiographic findings associated with outcomes of adult LT recipients. The risk of bias in included articles was assessed using ROBINS-E tool. Methodological quality varied from low to high across the risk of bias domains.
RESULTS RESULTS
Twenty-three studies were identified after the selection process; ten were enrollable for the meta-analyses. According to the results observed, the E/A ratio fashioned as a continuous value (HR = 0.43, 95%CI = 0.25-0.76; P = 0.003), and tricuspid regurgitation (HR = 2.36, 95%CI = 1.05-5.31; P = 0.04) were relevant predicting variables for post-LT death. Other echocardiographic findings failed to merge with statistical relevance.
CONCLUSION CONCLUSIONS
Tricuspid regurgitation and left ventricular diastolic dysfunction play a role in the prediction of post-LT death. More studies are needed to clarify further the impact of these echocardiographic features in the transplantation setting.

Identifiants

pubmed: 38417399
pii: S0955-470X(24)00021-1
doi: 10.1016/j.trre.2024.100838
pii:
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

100838

Informations de copyright

Copyright © 2024 Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest None.

Auteurs

Quirino Lai (Q)

General Surgery and Organ Transplantation Unit, Sapienza University of Rome, AOU Policlinico Umberto I, Rome, Italy. Electronic address: quirino.lai@uniroma1.it.

Miriam Caimano (M)

Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.

Francesca Canale (F)

General Surgery and Organ Transplantation Unit, Sapienza University of Rome, AOU Policlinico Umberto I, Rome, Italy.

Lucia Ilaria Birtolo (LI)

Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, AOU Policlinico Umberto I, Rome, Italy.

Flaminia Ferri (F)

Department of Translational and Precision Medicine, Sapienza University of Rome, AOU Umberto I Policlinico of Rome, Rome, Italy.

Stefano Ginanni Corradini (SG)

Department of Translational and Precision Medicine, Sapienza University of Rome, AOU Umberto I Policlinico of Rome, Rome, Italy.

Massimo Mancone (M)

Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, AOU Policlinico Umberto I, Rome, Italy.

Giuseppe Marrone (G)

Department of Translational Medicine and Surgery, Catholic University of Sacred Heart, Rome, Italy.

Daniela Pedicino (D)

Department of Cardiovascular Medicine, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.

Massimo Rossi (M)

General Surgery and Organ Transplantation Unit, Sapienza University of Rome, AOU Policlinico Umberto I, Rome, Italy.

Elisabetta Vernole (E)

Department of Translational Medicine and Surgery, Catholic University of Sacred Heart, Rome, Italy.

Maurizio Pompili (M)

Department of Translational Medicine and Surgery, Catholic University of Sacred Heart, Rome, Italy.

Marco Biolato (M)

Department of Translational Medicine and Surgery, Catholic University of Sacred Heart, Rome, Italy.

Classifications MeSH