title: Liver failure in total artificial heart therapy.
abstract: 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.
authors: Heart- and Vascular Center Duisburg, Department for the Surgical Therapy of End-stage Heart Failure and Mechanical Circulatory Support, Duisburg, Germany ;
authors: Alexandros Merkourios
authors: AM
authors: Dimitriou
authors: Department of Cardiac Surgery, University Heart Center Graz, Medical University of Graz, Austria.
authors: Otto
authors: O
authors: Dapunt
authors: Department of Cardiac Surgery, University Heart Center Graz, Medical University of Graz, Austria.
authors: Igor
authors: I
authors: Knez
authors: Department of Cardiac Surgery, University Heart Center Graz, Medical University of Graz, Austria.
authors: Andrae
authors: A
authors: Wasler
authors: Department of Cardiac Surgery, University Heart Center Graz, Medical University of Graz, Austria.
authors: Peter
authors: P
authors: Oberwalder
authors: Heart- and Vascular Center Duisburg, Department for the Surgical Therapy of End-stage Heart Failure and Mechanical Circulatory Support, Duisburg, Germany ;
authors: Reiner
authors: R
authors: Koerfer
authors: Heart- and Vascular Center Duisburg, Department for the Surgical Therapy of End-stage Heart Failure and Mechanical Circulatory Support, Duisburg, Germany ;
authors: Gero
authors: G
authors: Tenderich
authors: Department of Cardiac Surgery, University Heart Center Graz, Medical University of Graz, Austria.
authors: Sotirios
authors: S
authors: Spiliopoulos
keywords: Total artificial heart (TAH); liver failure