Background: Echocardiography is performed as part of preoperative evaluation of liver (LT) and kidney (RT) transplant recipients. Pathological findings, although associated with survival in the immediate perioperative period, have received less attention as markers of increased incidence of adverse outcomes in the long term. (1, 2) Aim: To establish the association of ≥ mild tricuspid regurgitation, mitral regurgitation (MR) and aortic stenosis with mortality, graft survival and posttransplant cardiovascular adverse events in kidney and liver transplant recipients.

Patients and Methods: Retrospectively collected data from 219 liver and 115 kidney transplant patients included parameters from one echocardiogram at a single-time point closest to transplantation, patient and graft survival periods, cause of death and CV events in the postoperative period (stroke and MI). Multiple organ transplants, patients lost to follow-up or with incomplete echocardiographic findings were excluded. Patient survival was defined as time from transplantation to death or last follow-up and graft survival as time from transplantation to last follow-up, death or re-transplantation.

Results: 199 LT and 106 RT patients met the inclusion criteria with median follow up 376±231 and 518±237 days respectively. Overall survival rate was 83.4% for LT and 94.3% for RT. Predominant cause of death was sepsis (43.8%) for LT while different causes of death were equally distributed between RT patients. Significant difference was found only for overall survival in MR (79.1%) and non-MR (94.6%) LT patient groups (log rank, p=0.013). No significant correlation was found between CV event incidence and any of the analyzed parameters.

Conclusion: In our study, MR was found to be associated with long-term posttransplant mortality in LT patients. The significance of echocardiography in risk-stratification for posttransplant outcomes in RT and LT is yet to be definitively determined in larger sample studies.