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. 2016 Jul;8(7):1546-9.
doi: 10.21037/jtd.2016.05.81.

Liver failure in total artificial heart therapy

Alexandros Merkourios Dimitriou  1 , Otto Dapunt  2 , Igor Knez  2 , Andrae Wasler  2 , Peter Oberwalder  2 , Reiner Koerfer  1 , Gero Tenderich  1 , Sotirios Spiliopoulos  2
Affiliations

Liver failure in total artificial heart therapy

Alexandros Merkourios Dimitriou et al. J Thorac Dis. 2016 Jul.

Abstract

Background: Congestive hepatopathy (CH) and acute liver failure (ALF) are common among biventricular heart failure patients. We sought to evaluate the impact of total artificial heart (TAH) therapy on hepatic function and associated clinical outcomes.

Methods: A total of 31 patients received a Syncardia Total Artificial Heart. Preoperatively 17 patients exhibited normal liver function or mild hepatic derangements that were clinically insignificant and did not qualify as acute or chronic liver failure, 5 patients exhibited ALF and 9 various hepatic derangements owing to CH. Liver associated mortality and postoperative course of liver values were prospectively documented and retrospectively analyzed.

Results: Liver associated mortality in normal liver function, ALF and CH cases was 0%, 20% (P=0.03) and 44.4% (P=0.0008) respectively. 1/17 (5.8%) patients with a normal liver function developed an ALF, 4/5 (80%) patients with an ALF experienced a markedly improvement of hepatic function and 6/9 (66.6%) patients with CH a significant deterioration.

Conclusions: TAH therapy results in recovery of hepatic function in ALF cases. Patients with CH prior to surgery form a high risk group with increased liver associated mortality.

Keywords: Total artificial heart (TAH); liver failure.

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Conflict of interest statement

Conflicts of Interest: G Tenderich is active as a surgical proctor by SynCardia Systems, Inc. None of the other authors is affiliated with SynCardia Systems, Inc. or any other manufacturers of commercial products discussed in the manuscript. Furthermore the authors disclose any discussion of unapproved use of any pharmaceutical or medical device in the manuscript. The other authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Median sGOT course in the three different groups. ALF, acute liver failure; CH, congestive hepatopathy; sGOT, serum glutamic oxaloacetic transaminase.
Figure 2
Figure 2
Median sGPT course in the three different groups. ALF, acute liver failure; CH, congestive hepatopathy; sGPT, serum glutamic-pyruvic transaminase.
Figure 3
Figure 3
Median bilirubin course in the three different groups. ALF, acute liver failure; CH, congestive hepatopathy.
See this image and copyright information in PMC

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