Predicting heart events after liver transplant

Northwestern Now: Summaries

CHICAGO - The first app and score to determine the one-year risk of a liver transplant patient dying or being hospitalized for a heart attack or other cardiovascular complication has been developed by Northwestern Medicine scientists.“Knowing the patient’s risk is critical to help prevent the frequent cardiac complications that accompany liver transplant surgery and to determine which patients are likely to survive the transplant,” said Dr. Lisa VanWagner, an assistant professor of medicine and preventive medicine at Northwestern University Feinberg School of Medicine and a Northwestern Medicine physician.Liver transplant surgery is among the highest-risk cardiac surgery. Unique blood flow changes occur in patients with end-stage liver disease. And during a liver transplant, massive changes in blood volume and adrenaline surges affect heart function.“Identifying persons who are at highest risk may mean restricting transplantation so that we maximize the benefit of scarce donor organs to persons who have a lower risk of a cardiac event and are more likely to survive the stress of a liver transplant,” VanWagner said.In those who are at higher risk, evaluation and consultation with a multidisciplinary team of physicians can help manage a wide array of cardiac conditions related to liver transplant patients.The new app and method to establish risk is called the Cardiovascular Risk in Orthotopic Liver Transplantation (CAR-OLT). It’s intended for use in those ages 18 to 75 with liver disease who are undergoing evaluation for liver transplantation.The app is both web-based (e.g., you can search the calculator and use it online) or you can download the app through a smartphone (iTunes or Google Play stores).The paper was published in the journal Hepatology July 13.Prior to the new Northwestern risk-scoring method, physicians used several risk tools that had been developed in a non-liver transplant population. One such tool, the revised cardiac risk index, is no better ...

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