Internal Medicine: Open Access
Open Access
ISSN: 2165-8048
ISSN: 2165-8048
Cornelius Njoku, Okechukwu Mgbemena and Joel Wedd
Imo State University Teaching Hospital, Nigeria
Emory University School of Medicine, USA
Scientific Tracks Abstracts: Intern Med
Background: Post-transplant cardiac complications are well known adverse events constituting major cause of morbidity and mortality in patients undergoing liver transplantation regardless of etiology of chronic liver disease. We evaluated 60-day postoperative cardiac complications for patients who had undergone PET stress testing for pre-operative evaluation. Methods: Patients with end-stage liver disease (ESLD) who underwent liver transplantation between 2009 and 2015 were reviewed. Patient demographics, risk factors, and short-term post-operative cardiac complications were collected and statistical analysis was performed. Results: A total of 31 patients (25 [81%] men and 6 (19%) women) with a mean age at transplantation of 55.3 y (range 3867) were identified. Cardiac risk factors include diabetes 15 (48%), hypertension 16 (52%) and current/former tobacco use 17 (55%). Contributing factors to ESLD are chronic HCV infection 17 (55%), alcohol abuse 9 (29%), NASH 9 (29%); PSC/ cholangiocarcinoma 1 (3%), sarcoidosis 1 (3%) and cryptogenic 1 (3%). Calculated MELD score for patients with pre-operative labs ranged from 10.1 to 29.2. All 31 patients had a PET stress testing for pre-operative assessment. 29 (93%) had a negative stress test. Post liver transplantation, only 1 (3%) patient had 3rd degree AV blocks attributable to ischemia at 60-day follow up. Other notable post-operative complications include hypotension 5(16%), acute renal failure 5(16%), acute pulmonary edema 2(6%) and congestive heart failure 4(13%). Conclusions: PET stress testing has a high negative predictive value for post-operative acute coronary syndromes in liver transplant patients (NPV=96.5%, 95%CI 96.22% - 96.88%).
Cornelius Njoku obtained a Bachelor of Medicine and Surgery from Imo State University, Nigeria. Currently, he is working as a Medical Officer at 19 Battalion Nigerian Army Barracks, Ondo State, Nigeria where he offers inpatient and outpatient care to Nigerian Army personnel. He is recently appointed as a Member of Board of Directors for Fortitudo Inc. a non-profit company based in Atlanta GA invested in providing cutting-edge healthcare for underserved populations around the world. In the past, he has volunteered for Nigerian Ministry of Defence/Walter Reed program Nigeria, IPAS Nigeria, Hands and Heart International Organization, South Eastern Nigeria Post Abortion Care Network. He is having certifications in data quality, monitoring and evaluation framework for HIV/AIDS program from Global Health eLearning center. Also a sexual and reproductive health and rights advocate. His research interests include cardiovascular outcomes and measures to improve them in both immunocompetent and transplant patients