Cardiac Evaluation in Liver Transplantation

AbstractPurpose of ReviewWith more than 14,000 patients awaiting liver transplantation in the USA and a mortality rate of 20 –25% on the wait list, a diligent pre-operative evaluation is crucial to ensure optimal risk assessment. Cardiac disease remains the leading cause of early mortality after liver transplantation. In this review, we discuss common cardiac comorbidities, frequently used testing modalities, and update d literature on cardiac evaluation in liver transplant candidates.Recent FindingsOptimal cardiac evaluation, especially in the asymptomatic patient, remains controversial as shown by conflicting results in the literature. Non-invasive testing is associated with low sensitivity in this patient population; therefore, coronary angiography remains the standard for detecting CAD.SummaryThere is general agreement that all liver transplant candidates have to undergo cardiac evaluation; however, universally accepted guidelines are currently not available. Often the choice of the cardiac evaluation modality has to be made on a case-by-case basis by a multidisciplinary transplant team based on the perceived risk of invasive studies when compared to perioperative cardiac events.
Source: Current Transplantation Reports - Category: Transplant Surgery Source Type: research