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Liver transplantation and atrial fibrillation: A meta-analysis
Journal article   Open access

Liver transplantation and atrial fibrillation: A meta-analysis

Ronpichai Chokesuwattanaskul, Charat Thongprayoon, Tarun Bathini, Patompong Ungprasert, Konika Sharma, Karn Wijarnpreecha, Pavida Pachariyanon and Wisit Cheungpasitporn
World journal of hepatology, Vol.10(10), pp.761-771
10/27/2018
DOI: 10.4254/wjh.v10.i10.761
PMCID: PMC6206153
PMID: 30386469
url
https://doi.org/10.4254/wjh.v10.i10.761View
Published (Version of record) Open Access

Abstract

AIM To assess prevalence of pre-existing atrial fibrillation (AF) and/or incidence of AF following liver transplantation, and the trends of patient's outcomes overtime; to evaluate impact of pre-existing AF and post-operative AF on patient outcomes following liver transplantation. METHODS A literature search was conducted utilizing MEDLINE, EMBASE and Cochrane Database from inception through March 2018. We included studies that reported: (1) prevalence of pre-existing AF or incidence of AF following liver transplantation; or (2) outcomes of liver transplant recipients with AF. Effect estimates from the individual study were extracted and combined utilizing random-effect, generic inverse variance method of DerSimonian and Laird. The protocol for this meta-analysis is registered with PROSPERO (International Prospective Register of Systematic Reviews, No. CRD42018093644). RESULTS Twelve observational studies with a total of 38586 liver transplant patients were enrolled. Overall, the pooled estimated prevalence of pre-existing AF in patients undergoing liver transplantation was 5.4% (95% CI: 4.9%-5.9%) and pooled estimated incidence of AF following liver transplantation was 8.5% (95% CI: 5.2%-13.6%). Meta-regression analyses were performed and showed no significant correlations between year of study and either prevalence of pre-existing AF (P = 0.08) or post-operative AF after liver transplantation (P = 0.54). The pooled OR of mortality among liver transplant recipients with pre-existing AF was 2.34 (2 studies; 95% CI: 1.10-5.00). In addition, pre-existing AF is associated with postoperative cardiovascular complications among liver transplant recipients (3 studies; OR: 5.15, 95% CI: 2.67-9.92, I-2 = 64%). With limited studies, two studies suggested significant association between new-onset AF and poor clinical outcomes including mortality, cerebrovascular events, post-transplant acute kidney injury, and increased risk of graft failure among liver transplant recipients (P < 0.05). CONCLUSION The overall estimated prevalence of pre-existing AF and incidence of AF following liver transplantation are 5.4% and 8.5%, respectively. Incidence of AF following liver transplant does not seem to decrease overtime. Preexisting AF and new-onset AF are potentially associated with poor clinical outcomes post liver transplantation. (c) The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
Gastroenterology & Hepatology Life Sciences & Biomedicine Science & Technology

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