The heart in liver transplantation

Area of Science:

• Cardiology
• Hepatology
• Transplantation Medicine

Background:

• The heart and liver share intricate physiological connections, influencing each other in health and disease.
• Liver disease and its treatments, including liver transplantation, can significantly affect cardiovascular function.
• Patients awaiting liver transplants often present with pre-existing cardiac conditions or develop them due to liver disease.

Purpose of the Study:

• To comprehensively review the multifaceted relationship between cardiac health and liver transplantation.
• To elucidate the cardiac implications across all phases of liver transplantation: pre-transplant, intra-operative, and post-transplant.

Main Methods:

• Literature review of studies examining heart-liver interactions in the context of liver transplantation.
• Analysis of cardiac conditions associated with liver disease etiology, the disease itself, and co-existing conditions.
• Evaluation of the cardiovascular stress associated with the liver transplantation procedure.

Main Results:

• Cardiac disease in liver transplant candidates can stem from the underlying liver disease cause (e.g., hemochromatosis), the liver disease itself, or associated conditions.
• Liver transplantation represents a significant cardiovascular stressor for patients with cirrhosis.
• Both pre-existing and new-onset cardiac diseases can manifest or progress after liver transplantation.

Conclusions:

• Understanding the heart-liver axis is critical for managing patients undergoing liver transplantation.
• Comprehensive cardiac assessment and management are essential throughout the peri-transplant period.
• Further research is warranted to optimize cardiovascular care for liver transplant recipients.