New app predicts cardiovascular events in liver transplant patients

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Scientists have developed the first app and score to determine one-year risk of a liver transplant patient dying or being hospitalised for myocardial infarction or other cardiovascular (CV) complication. 

Approximately one-third of liver transplant recipients will have a CV complication in the first year after a liver transplant. Until now however, doctors have depended on risk tools developed in non-liver transplant populations to estimate the risk for CV events after orthotopic liver transplantation (OLT).

The new Cardiovascular Risk in Orthotopic Liver Transplantation (CAR-OLT) score was developed using data from a cohort of 1,024 patients, aged 18-75 years, who underwent first OLT in a tertiary care teaching hospital over a 10-year period. Among the cohort, major cardiovascular disease (CVD) complications occurred in 32.1 per cent. The CAR-OLT point-based score was found to be superior to other published risk models for postoperative CVD morbidity and mortality.

Writing in Hepatology, the authors said further external validation of the findings in a larger multicenter clinical trial is needed to assess whether use of the CAR-OLT score for risk stratification and the decision to proceed with more intensive cardiovascular testing or targeted risk factor reduction would be helpful to improve CVD outcomes after OLT.