Enhancing Cardiovascular Risk Prediction in Patients undergoing Liver Transplantation

2021 Postdoctoral Fellowship  

Years funded: 2022-2023  

Liver disease affects at least 20% of Australians. Liver transplantation(LT) is the only curative treatment for patients with life-threatening liver disease. Dr Anoop Koshy's team have recently demonstrated cardiovascular(CV) disease to be a leading cause of death after LT in Australia. Although LT candidates undergo detailed CV assessment, our ability to predict the occurrence of cardiac complications is limited. 

Patients with liver disease have underlying cardiac structural changes. Dr Anoop Koshy's team have shown that these patients have an impaired cardiac reserve or an inability to augment their cardiac function under stress. This finding, considered an early marker of a condition known as ‘cirrhotic cardiomyopathy’, affects 1 in 3 patients undergoing LT. Using stress testing, the team aims to study whether an impaired cardiac reserve increases risk of CV events after LT. They will also aim to perform serial heart ultrasound scans to investigate whether LT can reverse ‘cirrhotic cardiomyopathy’. Early diagnosis and treatment of this condition could reduce the risk of CV events after LT.