Multigated radionuclide blood pool scans (MUGA) for preoperative assessment of patients undergoing orthotopic liver transplantation (OLT)

Introduction

OLT is a major cardiovascular stress both intra- and postoperatively. The ideal preoperative cardiac screening test for patients with end-stage liver disease (ESLD) has not been determined [1]. We evaluated the value of MUGA in predicting perioperative morbidity and mortality in patients undergoing OLT.

Methods

After IRB approval we retrospectively examined the medical records of 170 ESLD patients who had MUGA scans prior to OLT from January 1994-April 1998. Morbidity was defined as reperfusion syndrome (fall in MAP >33%), requirement for intraor postoperative inotropes, myocardial infarction (AMI), need for haemodiafiltration or ICU stay >5 days. Mortality was restricted to 30 days. MUGA scans were defined as normal if ejection fraction (EF) was >55% [2]. Analysis of results was by Chi-squared test.

Results

There were 127 patients in group A (EF >55%) and 37 patients in group B (EF <55%). Six patients were excluded because of incomplete data. No patients had AMI. Two patients in group A died and there were no deaths in group B.

Conclusion

For patients undergoing OLT, MUGA is not a useful screening test for predicting perioperative morbidity and mortality. Based upon these findings we have revised our method of pre-operative cardiac assessment of patients presenting for OLT.

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