Predicting Heart Problems After Liver Transplant

A study comparing the scores of three global cardiovascular disease risk-stratification algorithms in liver transplant patients found that two of the methods were better than the third.

Researchers at Virchow-Klinikum (Berlin, Germany) retrospectively studied 303 patients who had received a liver transplant between 1988 and 1994. They gathered clinical and demographic data at six months post-transplant and used it to calculate three established cardiovascular risk scores: the Framingham risk score (FRS), the German prospective cardiovascular Münster study (PROCAM), and the European systematic coronary risk evaluation project (SCORE), all of which predict the 10-year-risk of coronary or cardiovascular events or fatalities.

The researchers, led by Dr. Olaf Guckelberger of the department of general, visceral, and
transplantation surgery at the clinic, then compared the actual incidence of cardiovascular events, such as myocardial infarction (MI) and coronary heart disease over 10 years post-transplant to better understand the predictive power of each score. They found that PROCAM and SCORE provided excellent measures to discriminate between patients at high or low risk for coronary events, but that the Framingham risk score did not identify high-risk liver transplant recipients as accurately. The findings were published in the March 2006 issue of Liver Transplantation.

Patients who receive liver transplants often have an increased prevalence of cardiovascular risk factors, and cardiovascular events are a major source of their morbidity and mortality. Due to excellent long-term survival, there is an increasing emphasis on identifying transplant recipients at risk for immunosuppression-related late complications.



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Virchow-Klinikum