Assessing the liver to predict outcomes in heart transplantation

Givertz, Michael M.

doi:10.1016/j.healun.2015.04.002

Cited by 8 publications

(2 citation statements)

References 25 publications

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“…21 Moreover, these patients with liver dysfunction had worse renal function, increased rates of tricuspid regurgitation, and a higher post-operative mortality. 7,22 Several risk-scoring systems previously introduced have failed to adequately assess and address these risks in the presence of liver abnormalities. 20 MELD-XI score was proposed to enable assessment of liver function in patients taking factor Xa inhibitors.…”

Section: Discussionmentioning

confidence: 99%

“…obtained liver tissue from 59 patients undergoing HT and reported 50% of patients meeting criteria for grade 3 or 4 hepatic fibrosis 21 . Moreover, these patients with liver dysfunction had worse renal function, increased rates of tricuspid regurgitation, and a higher post‐operative mortality 7,22 . Several risk‐scoring systems previously introduced have failed to adequately assess and address these risks in the presence of liver abnormalities 20 .…”

Section: Discussionmentioning

confidence: 99%

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Utilization of hepatitis C virus infected donors in heart transplant recipients with elevated MELD‐XI score

Hirani,

Okumura,

Isath

et al. 2023

Clinical Transplantation

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BackgroundThe advent of direct‐acting antivirals has helped to increase the safe utilization of organs from hepatitis C virus positive (HCV+) donors. However, the outcomes of heart transplantation (HT) using an HCV+ donor are unclear in recipients with underlying liver disease represented by an elevated model for end‐stage liver disease excluding international normalized ratio (MELD‐XI).MethodsThe United Network of Organ Sharing database was queried from Jan 2016 to Dec 2021. Post‐transplant outcomes stratified by recipient MELD‐XI score (low <10.37, medium, 10.38–13.39, and high >13.4) was compared between patients with HT from HCV+ (N = 792) and patients with HT from HCV‐negative donors (N = 15,266).ResultsThe median MELD‐XI score was comparable (HCV+, 12.1, vs. HCV‐negative, 11.8, p = .37). In the HCV+ group, donors were older (33 vs. 31 years, p < .001). Ischemic time of donor hearts (3.48 vs. 3.28 h, p < .001) and travel distance (250 vs. 157 miles, p < .001) were longer in HCV+ group. In the Kaplan Meier analysis with a median follow‐up of 750 days, survival was comparable between the two groups (2‐year survival, MELD‐XI Low: HCV+, 92.4 ± 3.6% vs. HCV‐negative, 91.1 ±.8%, p = .83, Medium: HCV+ 89.2 ± 4.3% vs. HCV‐negative, 88.2 ± 1.0%, p = .68, and High: HCV+, 84.9 ± 4.5% vs. HCV‐negative, 84.6 ± 1.1%, p = .75) In multivariate Cox hazard models, HCV donors were not associated with mortality in each MELD‐XI subgroup (Low: adjusted hazard ratio (aHR), 1.02, p = .94; Medium: aHR, .95, p = .81; and High: aHR, .93, p = .68).ConclusionUtilization of HCV+ hearts was not associated with an increased risk of adverse outcomes in recipients with an elevated MELD‐ XI score.

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