Evaluation of Elevated Liver Enzymes and their Association with Increased Risk of Perioperative Mortality in Heart Transplant Patients

Background: Cardiovascular disease, which itself can lead to liver disorders, is known as the most common cause of death in many countries, including Iran. Elevated liver enzymes can increase mortality risk after transplantation in most heart surgeries. This study aimed to investigate the effect of elevated liver enzymes before and after transplantation on the risk of perioperative mortality in heart transplant patients. Methods: The information of this historical cohort study was prepared using patients’ hospital records from 2014 to 2019. The data belonged to demographic information, medical history, and laboratory data of 203 patients admitted to Dr. Masih Daneshvari Hospital. More than three times normal institutional ranges defined elevated liver enzymes. Also, the number of deaths within 30 days after transplantation was considered to determine perioperative mortality. The Chi-square test and regression method were used to analyze the data using SPSS software. Results: Mortality of patients with elevated liver enzymes before and on the first, second, and third days after heart transplantation was 4.08, 3.95, 3.75, and 4.89 times higher than those with normal liver enzymes, respectively. Increasing the Model for End-Stage Liver Disease (MELD) score was associated with a significantly increased risk of death (p<0.001). Conclusion: Elevated liver enzymes before or three days after heart transplantation are significantly associated with perioperative transplant death. Optimization of liver function before transplantation can play an important role in preventing mortality.