Cirrhotic Cardiomyopathy and Cardiac Failure after Liver Transplantation: A Case Series

Area of Science:

• Cardiology
• Transplantation Medicine
• Critical Care Medicine

Background:

• Preoperative cardiac functional assessment is crucial but debated in liver transplantation.
• Significant cardiac events contribute to a notable percentage of mortality post-transplant.
• Current guidelines and practices for cardiac evaluation prior to liver transplant vary.

Observation:

• A case series of three patients undergoing orthotopic liver transplantation is presented.
• All patients exhibited normal preoperative cardiac assessments with no significant hemodynamic abnormalities.
• Postoperatively, all three patients developed significant cardiac dysfunction.

Findings:

• Each patient's postoperative cardiac failure stemmed from distinct and unrelated diagnoses.
• The findings suggest that preoperative cardiac assessments may not always predict postoperative cardiac complications.
• The diverse etiologies of cardiac failure underscore the complexity of cardiac management in liver transplant recipients.

Implications:

• This case series suggests that normal preoperative cardiac function does not preclude the development of severe postoperative cardiac dysfunction.
• It highlights the potential limitations of current preoperative cardiac assessment protocols in identifying all at-risk liver transplant candidates.
• Further research is warranted to refine cardiac risk stratification and postoperative monitoring strategies in liver transplantation.