Key result
Intraoperative hs-cTnI elevation linked to ~170% higher risk of severe liver transplant complications.
Why the study?
The association between intraoperative increases in high-sensitivity cardiac troponin I and severe postoperative complications after liver transplantation was not well established.
Does intraoperative hs-cTnI elevation predict severe postoperative complications in patients undergoing liver transplantation?
Observational (n=233)
Does intraoperative hs-cTnI elevation predict severe postoperative complications in patients undergoing liver transplantation?
Odds Ratio: 2.7 (95% CI 1.14–6.4)
Absolute Event Rate: 29.2% vs 11.8%
p-value: p=0.005
Intraoperative elevation of high-sensitivity cardiac troponin I is an independent predictor of severe, life-threatening postoperative complications within four weeks following liver transplantation.
May support perioperative troponin monitoring in liver transplant; hypothesis-generating and should not yet change practice.
BACKGROUND: We aim to evaluate the association between intraoperative increases in high-sensitivity cardiac troponin I (hs-cTnI) and severe postoperative complications (sPOC), defined as Clavien-Dindo grade IV or V, within the first four weeks after liver transplantation. METHODS: The study included 233 patients who were stratified based on whether hs-cTnI levels at the end of surgery were above the 99th percentile. RESULTS: The incidence of sPOC was significantly higher in patients with cTE (29.2% vs. 11.8%; p = 0.001), who also had a higher incidence of respiratory failure (p = 0.015), acute kidney injury (p < 0.001), renal replacement therapy (p = 0.001), and re-interventions within four weeks (p = 0.028). Multivariate analysis identified hs-cTnI levels as independent predictor of sPOC (OR: 2.70[1.14-6.40], p = 0.005). CONCLUSIONS: Intraoperative hs-cTnI elevation was independently associated with sPOC. These must be interpreted in the context of the observational study design and the possibility of residual confounding.
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Duque et al. (2026) conducted an observational in Liver transplantation (n=233). Intraoperative high-sensitivity cardiac troponin I (hs-cTnI) elevation above the 99th percentile vs. hs-cTnI levels not above the 99th percentile was evaluated on Severe postoperative complications (sPOC), defined as Clavien-Dindo grade IV or V, within the first four weeks (OR 2.70, 95% CI 1.14-6.40, p=0.005). Intraoperative hs-cTnI elevation above the 99th percentile predicted severe postoperative complications after liver transplantation (29.2% vs 11.8%; OR 2.70; 95% CI 1.14-6.40; p=0.005).
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