PhD Scientific Days 2026

Poster Session 2.Q - Cardiovascular Medicine and Research

Preoperative Liver Dysfunction Scores and Survival after Durable Left Ventricle Assist Device Implantation

Name of the presenter

Bottlik, Olívia

Institute/workplace of the presenter

Semmelweis University

Authors

Dr. Olívia Bottlik¹
1: Semmelweis University

Text of the abstract

Introduction: Mechanical cardiac support prolongs survival in end-stage heart failure patients. Right ventricular and end-organ dysfunction are associated with worse survival after LVAD implantation.
Aims: The aim of this study was to evaluate the severity of preoperative hepatic risk on 30-day mortality and overall survival by calculating scores used to predict the urgency of liver transplantation. The patient cohort consisted of patients after LVAD implantation, either with or without temporary support with a right ventricular assist device (RVAD).
Method: In this retrospective, single-center analysis, we included 107 patients with a Heartmate (HM) 2 or 3 implantation between 2013 and 2026. We obtained survival data and preoperative laboratory results from our electronic records and calculated three different liver dysfunction assessment scores: MELD 3.0 (Model for End-Stage Liver Disease), MELD-XI (Model for End-Stage Liver Disease eXcluding INR), and Fib-4 (Fibrosis-4 index for Liver Fibrosis). The IBM SPSS Statistics software package was used.
Results: In our cohort, fourteen patients received HM2 devices, and ninety-three HM3 (86,9%). Thirty-seven patients needed RVAD (34,58%) therapy. 26 patients (25,23%) subsequently received a heart transplant. Overall survival was 42,81 months (IQR: 7,47 - 67,73 months). Thirty-day survival was 89,72%. The need for RVAD was associated with worse survival (RVAD: 75,68%; no RVAD: 97,14%; p = 0,001). In our multivariable Cox regression model of overall survival, MELD 3.0 (AHR: 1,061, 95% CI: 1,005 - 1,121; p = 0,033) and Fib-4 (AHR: 1,482, 95% CI: 1,005 - 2,186; p = 0,047) scores were independently associated with overall mortality.
Conclusion: Right ventricular failure increased short-term mortality, and preoperative liver dysfunction was associated with worse overall survival. Our analysis shows that MELD 3.0 and Fib-4 scores derived from preoperative laboratory values could be useful tools for predicting long-term survival.
Funding: This retrospective analysis of electronic records did not receive any grants or funding.