The goal of this multicenter observational study is to determine whether preoperative statin use reduces major adverse cardiovascular events or other complications after liver transplantation. The main question it aims to answer is: Does preoperative statin use reduce major adverse cardiovascular events or other complications after liver transplantation? The records of participants who already took statins before liver transplantation will be reviewed.
Cardiovascular complications have emerged as a leading cause of early postoperative death following liver transplantation (LT), accounting for over 40% of early deaths. As a result, preventing postoperative cardiac complications has become a critical concern in the management of LT recipients. Statin therapy has been suggested to improve perioperative and long-term outcomes in various surgical populations, primarily through LDL cholesterol reduction as well as pleiotropic effects, such as enhanced endothelial function and anti-inflammatory actions. However, evidence specifically examining the impact of preoperative statin therapy on cardiovascular outcomes after LT remains limited, highlighting the need for further research in this population. This study aimed to address the current knowledge gap by investigating the association between preoperative statin use and the incidence of major adverse cardiovascular events within 30 days after liver transplantation in liver transplant recipients. Secondary outcomes included overall mortality, graft failure, early allograft dysfunction, acute kidney injury, and length of stay in the intensive care unit.
Study Type
OBSERVATIONAL
Enrollment
6,898
Administration of any statin medication prior to liver transplantation. Statin therapy was previously prescribed by the treating physician before the transplant procedure, not assigned by the study protocol.
Asan Medical Center
Seoul, South Korea
30-day Major Adverse Cardiovascular Events
The composite of cardiovascular death, heart failure, myocardial infarction, atrial fibrillation, ventricular arrhythmia, ischemic electrocardiogram changes (ST-segment depression or elevation) with chest tightness, pulmonary embolism, and stroke
Time frame: 30 days after liver transplantation
Acute Kidney Injury
Occurrence of acute kidney injury within 7 days post-transplantation, diagnosed according to the Kidney Disease: Improving Global Outcomes (KDIGO) criteria
Time frame: Within 7 days after liver transplantation
Early Allograft Dysfunction
Defined as serum bilirubin \>10 mg/dL or international normalized ratio (INR) \>1.6 on postoperative day (POD) 7, or alanine/aspartate aminotransferases \>2000 IU/L within 7 days after transplantation
Time frame: Within 7 days after liver transplantation
Intensive Care Unit Length of Stay
Total duration (days) of intensive care unit stay after liver transplantation
Time frame: From the date of liver transplantation until intensive care unit discharge, up to 600 days
Overall Mortality
Death from any cause after liver transplantation
Time frame: From the date of liver transplantation to Mar 22, 2026
Overall Graft Failure
Recipient death or retransplantation for any cause
Time frame: From the date of liver transplantation to Mar 22, 2026
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