Liver failure in total artificial heart therapy.
BACKGROUND
Congestive hepatopathy (CH) and acute liver failure (ALF) are common among biventricular heart failure patients. We sought to evaluate the impact of total artificial heart (TAH) therapy on hepatic function and associated clinical outcomes.


METHODS
A total of 31 patients received a Syncardia Total Artificial Heart. Preoperatively 17 patients exhibited normal liver function or mild hepatic derangements that were clinically insignificant and did not qualify as acute or chronic liver failure, 5 patients exhibited ALF and 9 various hepatic derangements owing to CH. Liver associated mortality and postoperative course of liver values were prospectively documented and retrospectively analyzed.


RESULTS
Liver associated mortality in normal liver function, ALF and CH cases was 0%, 20% (P=0.03) and 44.4% (P=0.0008) respectively. 1/17 (5.8%) patients with a normal liver function developed an ALF, 4/5 (80%) patients with an ALF experienced a markedly improvement of hepatic function and 6/9 (66.6%) patients with CH a significant deterioration.


CONCLUSIONS
TAH therapy results in recovery of hepatic function in ALF cases. Patients with CH prior to surgery form a high risk group with increased liver associated mortality.
['Dimitriou|Alexandros Merkourios|AM|', 'Dapunt|Otto|O|', 'Knez|Igor|I|', 'Wasler|Andrae|A|', 'Oberwalder|Peter|P|', 'Koerfer|Reiner|R|', 'Tenderich|Gero|G|', 'Spiliopoulos|Sotirios|S|']
liver failure Total artificial heart (TAH)