None listed
Conditions
Brief summary
Cardiac dysfunction is a common complication of cirrhosis, affecting from a third to half of patients with end stage liver disease. The reasons for its development are still unclear, and novel techniques such as metabolite profiling may illuminate new causative pathways and potentially identify targets for treating this condition. Liver transplantation provides a cure for cirrhosis, however its effect on cardiac dysfunction has also not been fully elucidated. Also, the effects of cardiac dysfunction on liver transplant outcomes in also unclear. This study, by combining metabomics and newer cardiac imaging techniques, will be able to study the reversibility of this condition after transplant and allow us to characterise the spectrum of cardiac dysfunction and its effect on liver transplant outcomes.
Interventions
The are no medical interventions in this trial. All patients will be undergoing tests as part of their standard assessment for liver transplantation. Some additional tests may be required as part of the trial.
Patients will undergo a blood collection to be used for metabolomic analysis. This will be done, where possible, during the same venepuncture as their standard liver transplant pathology collection. Blood collection will be repeated at 6 months post liver transplantation. Again, where po
The are no medical interventions in this trial. All patients will be undergoing tests as part of their standard assessment for liver transplantation. Some additional tests may be required as part of the trial. Patients will undergo a blood collection to be used for metabolomic analysis. This will be done, where possible, during the same venepuncture as their standard liver transplant pathology collection. Blood collection will be repeated at 6 months post liver transplantation. Again, where possible, this will be done coinciding with pathology required for routine clinical care. . Patients will undergo dobutamine stress echocardiography (DSE) prior to liver transplantation, to aid in diagnosis of cardiac dysfunction, in particular contractile reserve and stress diastology. DSEs are performed in many patients as a standard part of a liver transplant work up, but will be performed in all patients as part of this trial. Patients with abnormalities consistent with cirrhotic cardiomyopathy on their pre-transplant DSE will undergo a post-transplant DSE at 6 months after transplant, to assess for reversibility of these changes. The test takes 30 minutes and will be performed at The Royal Prince Alfred Cardiology Department in Camperdown, NSW.
Sponsors
Dr Madeleine Gill
Eligibility
Sex/Gender
All
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
Patients undergoing assessment for liver transplantation at the Australian National Liver Transplant Unit at The Royal Prince Alfred Hospital will be prospectively recruited
Exclusion criteria
1) Patients with non-cirrhotic indications for liver transplant 2) Patients undergoing multi-organ transplantation 3) Patients with haemodynamically significant valvular heart disease, non-revascularised coronary artery disease, or any pre-existing non-cirrhotic cardiomyopathy 4) Patients with underlying liver diseases that can potentially cause infilitrative cardiovascular disease such as amyloidosis, sarcodosis, or haemochromotosis
Outcome results
None listed