Pre-liver transplantation, cardiac assessment

Chirurgia (Bucur). 2012 May-Jun;107(3):283-90.

Abstract

Liver transplantation (LT) is a stressful condition for the cardiovascular system of patients with advanced hepatic disease. The underlying hemodynamic and cardiac status of patients with cirrhosis is crucial to determine which patients should became recipients. In addition to advanced age and the presence of comorbidities, there are specific cardiovascular responses in cirrhosis that can be detrimental to the LT candidate. Patients with cirrhosis requiring LT usually demonstrate increased cardiac output, a compromised ventricular response to stress, low systemic vascular resistance and bradycardia. Post-transplant reperfusion may result in cardiac death due to a multitude of causes, including arrhythmia, acute heart failure and myocardial infarction. This review examines screening strategies for transplant candidates and details the prognostic value of common test used to identify ischemic heart disease, heart failure, portopulmonary hypertension. There are discused evidence-based recommendations for their evaluation and management.

Publication types

  • Review

MeSH terms

  • Cardiovascular Diseases / complications
  • Cardiovascular Diseases / diagnosis*
  • Cardiovascular Diseases / physiopathology
  • Cardiovascular Diseases / prevention & control
  • Evidence-Based Medicine
  • Heart Function Tests
  • Hemodynamics
  • Humans
  • Liver Cirrhosis / complications
  • Liver Cirrhosis / physiopathology
  • Liver Cirrhosis / surgery*
  • Liver Transplantation*
  • Mass Screening
  • Patient Selection
  • Practice Guidelines as Topic
  • Preoperative Care*
  • Prognosis
  • Risk Assessment
  • Risk Factors