Cardiovascular Considerations in Liver TransplantationA Review of Risks, Diagnostics, and Management

Abstract

Vatsalkumar Jetani, Utsav Vaghani, Devangkumar Lakhani, Vidit Jogani, Niralkumar Ghevariya, Ishita Sanghani and Akash Patel

This comprehensive review article delves into the critical role of cardiovascular disorders in liver transplantation (LT) candidates, focusing on coronary artery disease (CAD), cirrhotic cardiomyopathy (CCM), and structural heart disease. It examines the prevalence and implications of these conditions on LT outcomes, emphasizing the necessity of a thorough preoperative cardiac evaluation and risk stratification. The article explores various aspects of cardiac risk in LT, including CAD, CCM, and coexisting structural heart diseases. It highlights the importance of diagnostic techniques such as echocardiography, stress testing, cardiac catheterization, and CMR in the evaluation process. The review aligns with current guidelines from major cardiac societies and discusses the implications of CCM and structural heart disease on LT. It also assesses the role of cardiac biomarkers in predicting postoperative outcomes and explores functional cardiopulmonary assessment tools. Finally, the article considers the intraoperative and postoperative cardiac risks associated with LT, concluding with the significant impact of cardiovascular management in improving LT outcomes.

PDF