Original scientific paper
https://doi.org/10.3325/cmj.2025.66.194
Risk factors associated with adverse cardiovascular events during orthotopic liver transplantation and the early post-transplant period
Nataša Višković Filipčić
; Department of Cardiology and Surgery, Special Hospital Agram, Zagreb, Croatia
Katarina Tomulić Brusich
; Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Centre Rijeka, Rijeka, Croatia
Milan Milošević
; Department of Environmental Health, Occupational and Sports Medicine, Andrija Štampar School of Public Health, Zagreb, Croatia
Sonja Perkov
; Department for Medical Biochemistry and Laboratory Medicine, University Hospital Merkur, Zagreb, Croatia
Miroslav Župčić
; Department of Clinical Sciences II, Faculty of Health Studies, University of Rijeka, Rijeka, Croatia
Tajana Filipec Kanižaj
; Department of Gastroenterology, University Hospital Merkur, School of Medicine, University of Zagreb, Zagreb, Croatia
*
* Corresponding author.
Abstract
Aim To evaluate the incidence of severe adverse cardio
vascular events during orthotopic liver transplantation and
the early post-transplant period, and to determine the fac
tors associated with these events.
Methods We retrospectively reviewed the medical records
of 291 patients who underwent orthotopic liver transplan
tation at University Center Merkur, Zagreb, Croatia, from
2013 to 2015. Data on corresponding donor characteristics
were sourced from the Eurotransplant database. Severe
adverse cardiovascular events were defined as myocardi
al infarction, malignant arrhythmia, pulmonary embolism,
cardiac failure, cardiac arrest, and death.
Results The incidence of severe adverse events was 8.9%.
Univariate analysis demonstrated a positive predictive val
ue linking severe adverse cardiovascular events with meta
bolic liver disease, an elevated model for end-stage liver
disease, an international normalized ratio, and the preop
erative administration of vasopressors. Multivariate analy
sis identified significant predictors of adverse events: liver
metabolic diseases (odds ratio [OR] 4.88; 95% confidence
interval [CI] 1.48-16.09; P = 0.009), donor arterial hyperten
sion (OR 2.68; 95% CI 1.01-7.18; P = 0.049), prolonged cold
ischemia duration (OR 1.22; 95% CI 1.01-1.49; P = 0.044),
and increased recipient age (OR 1.09; 95% CI 1.03-1.16;
P = 0.005).
Conclusion The occurrence of severe adverse cardiovas
cular events is markedly greater than previously docu
mented. We propose the use of a scoring system including
known risk variables to identify patients at risk of adverse
cardiovascular events, hence improving surveillance for an
early intervention.
Keywords
Hrčak ID:
352488
URI
Publication date:
25.6.2025.
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