Poster Session 1: Infections and Acute on Chronic Liver Failure
Bibliographic record
Abstract
Background: Combined heart and liver transplantation (CHLT) is the treatment option for patients with end-stage heart and liver disease.This is a review of nine patients who underwent combined heart and liver transplant at a single center.Methods: We conducted a detailed retrospective examination of nine patients who underwent simultaneous combined heart and liver transplantation at our institution from 2004 to 2013.Statistical analysis was performed using descriptive and Kaplan-Meier analyses.Results: Eight patients received combined heart and liver transplantation and one patient received combined heart, liver and lung transplantation.Mean age was 53.2 + 11.3 years, 8 (78%) were male and 8 (78%) were white.Median biological MELD score was 13 (range, 6-20), and median BMI was 27 (range 15-31).Cardiac transplant indications were ischemic cardiomyopathy in 2 (22%), non-ischemic cardiomyopathy in 2 (22%), hemochromatosis in 3 (34%), ATTR-amyloidosis in 1 (11%) and pulmonary hypertension with end stage right heart failure in 1 (11%).All patients, but one with amyloidosis, had documented cirrhosis on liver biopsy.Eight (88%) patients had simultaneous heart and liver transplant within the same operation, while one patient had a heart and lung trans-plantation followed by a liver transplantation 24 hours apart.Observed patient year to date survival rates at 1, 3 and 5 years were 100%, 88% and 88% respectively, compared to our isolated heart transplant (n=222) at 91.6%, 77.5% and 71.1%.Among the nine patients who underwent CHLT, only two patients (22%) had one cardiac rejection episode based on biopsy (ISHLT grade 2R) in the presence of stable cardiac allograft function, and there were no liver rejection events in all nine patients.The mean left ventricular ejection fraction (LVEF) at 1-year follow-up was 63 3%.At 5-year follow-up (n=6), there was no evidence of cardiac allograft vasculopathy by direct angiography.Five patients (55.6%) developed acute kidney injury requiring hemodialysis or renal replacement therapy within 30 days post transplantation.No patient developed endstage renal failure at the mean follow up of 59 + 36 months.Conclusion: With proper patient selection, favorable short and long-term outcomes can be achieved in patients who receive combined heart and liver transplantation.Post-transplant acute kidney injury is not uncommon, however it is not associated with long-term sequelae.MELD = Model for End-Stage Liver Disease BMI = Body Mass
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".