P2852 - POSTER WITHDRAWN

Hong T. Lin, MD, Antonio Alvarez Castaneda, MD, Khalid Mumtaz, MBBS, MSc, Chathur Acharya, MBBS
The Ohio State University Wexner Medical Center, Columbus, OH

Introduction: Patients with right ventricular (RV) dysfunction experience poorer outcomes following liver transplantation, largely due to cardiovascular complications. As a result, transplant surgeons and hepatologists commonly utilize echocardiograms to evaluate this risk prior to transplantation, primarily looking at RV size and right ventricular systolic pressure (RVSP). This study aims to assess the significance of right ventricular dilation (RVD), a marker of ventricular dysfunction, as an independent predictor of peri- and post-transplant outcomes.



Methods: We retrospectively examined demographic, echocardiography, and outcome data from liver transplant patients at The Ohio State University from January 2016 to April 2020. Patients diagnosed with acute liver failure, pulmonary hypertension, and end-stage renal disease (ESRD) undergoing hemodialysis were excluded. Only echocardiograms conducted within one year before transplant were considered. RVD was defined as a base diameter exceeding 42 mm, mid-cavity diameter surpassing 35 mm, or longitudinal diameter exceeding 86 mm.



Results: The original dataset comprised 464 liver transplant recipients, of which 255 patients met inclusion criteria. Among them, 71 were found to have RVD. The majority were male (65%) and white (91%). Mean RV basal diameter was 37 ± 6 mm and the median RVSP was 28 with interquartile range (IQR) of 14. Table 1 summarizes and compares demographics and outcomes between the dilated RV group and the non-dilated RV group. As expected, the group with dilated RV has a significantly higher median RVSP compared to the group with non-dilated RV. However, while the basal RV diameter correlated weakly with RVSP (r=0.2, p=0.0034) for the whole cohort, there was no significant difference in RVSP between the enlarged RV basal diameter group and the normal RV basal diameter group (r=0.08, p=0.57).



Discussion: Isolated RVD is a common finding in cirrhotic patients under consideration for liver transplantation. It correlates with RVSP but is a poor independent predictor of overall length of stay and graft loss during the index admission, as well as 30- or 90-day readmission for liver-related complications and all-cause mortality 90 days post-transplant. This limits the clinical applicability of RV parameters. As such, findings of RV dilation in the absence of reported RVSP should not immediately prompt a right heart catheterization.




Disclosures:


Hong T. Lin, MD, Antonio Alvarez Castaneda, MD, Khalid Mumtaz, MBBS, MSc, Chathur Acharya, MBBS. P2852 - POSTER WITHDRAWN, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.