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Preoperative cardiovascular investigations in liver transplant candidate: An update

Lalit Sehgal1, Piyush Srivastava2, Chandra Kant Pandey3

  • 1Liver Transplant Anaesthesia and Critical Care (SICU), Rajiv Gandhi Cancer Institute and Research Centre, Rohini, New Delhi, India.

Indian Journal of Anaesthesia
|March 11, 2016
PubMed

Insights

Cardiovascular complications are a significant risk for liver transplant recipients. This review examines evidence for diagnosing and stratifying cardiovascular risk in end-stage liver disease patients before transplantation.

Area of Science:

  • Cardiology
  • Hepatology
  • Transplantation Medicine

Background:

  • Cardiovascular complications significantly impact morbidity and mortality in end-stage liver disease (ESLD) patients undergoing liver transplantation.
  • Ischemic heart disease is a primary contributor to these complications, necessitating thorough preoperative evaluation.
  • ESLD patients often exhibit unique cardiovascular profiles, including high cardiac output and compromised ventricular function.

Purpose of the Study:

  • To critically review the current evidence on diagnosing and risk-stratifying cardiovascular disorders in liver transplant candidates.
  • To address the ongoing controversy regarding optimal screening methodologies for cardiovascular disease in this population.

Main Methods:

  • Systematic review of the rapidly expanding body of evidence.
  • Critical analysis of diagnostic and risk stratification strategies for cardiovascular disorders.

Main Results:

  • Evidence suggests a need for comprehensive cardiovascular assessment in ESLD patients awaiting liver transplantation.
  • Current screening methodologies show considerable controversy and require further refinement.
  • Accurate risk stratification is crucial for optimizing patient outcomes.

Conclusions:

  • Preoperative cardiovascular risk assessment is essential for improving outcomes in liver transplant recipients.
  • Further research and consensus on screening methodologies are needed to effectively manage cardiovascular risks in ESLD patients.
  • Optimizing the identification of high-risk candidates is paramount for successful liver transplantation.

Keywords:
Cardiovascular system evaluationliver transplantpreoperative evaluation

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