Variables hemodinámicas cardiacas y desenlaces postrasplante hepático, en un centro de referencia en trasplantes de Colombia a 2600 metros sobre el nivel del mar
Thesis
Introduction: Hemodynamic assessment by Doppler echocardiography is important in the identification of alterations systolic/diastolic as a predictor of post-liver transplant outcomes from cardiovascular alterations to dysfunction graft and mortality. Objective: To describe the relationship between the hemodynamic variables measured by transthoracic echocardiogram with the outcomes post-liver transplant as heart failure, graft dysfunction and mortality in patients diagnosed with liver cirrhosis in LaCardio between the period from January 1, 2005 to July 31, 2021. Materials and methods: Retrospective cohort study. Patient with liver transplant at LaCardio hospital, in Bogotá, Colombia between January 2005 and July 2021. Analysis of sociodemographic variables, comorbidities, echocardiography and intraoperative variables, with primary outcomes such as early graft dysfunction, acute kidney injury, and mortality during follow-up. It became a logistic regression for the estimation of odds ratio (OR). Results: 397 patients were analyzed, with 54.4% men, finding 71% with some degree of diastolic dysfunction, Hypertrophy left ventricular (30.9%) with presence of graft dysfunction in 8% and presentation of acute kidney injury (AKI) in 21% and a 15% mortality during study follow-up. In the CART model for mortality and graft dysfunction outcomes it was related to the presence of BMI<19 or the combination of BMI between 19 and <24 with dialysis. Conclusions: The findings in the study regarding diastolic alterations, or related variables such as LVH or increased PSAP and post-transplant infections correlate with outcomes in mortality and presence of AKI. On the other hand, the presence of AKI or RRT requirement correlates with early graft dysfunction.
