Management of cardiac diseases in liver transplant recipients: Comprehensive review and multidisciplinary...

Area of Science:

• Cardiology
• Hepatology
• Transplantation Medicine

Background:

• Cardiac diseases are a leading cause of morbidity and mortality in liver transplant recipients (LTRs).
• The incidence of cardiac disease in LTRs is increasing, particularly in older patients and those with non-alcoholic steatohepatitis.
• A multidisciplinary approach is needed to address the rising burden of cardiac conditions post-transplantation.

Purpose of the Study:

• To critically review the literature on the epidemiology, risk assessment, and mitigation of cardiac diseases in LTRs.
• To formulate practice-based recommendations for managing coronary heart disease, arrhythmia, heart failure, and valvular heart disease in this population.
• To identify knowledge gaps and guide future research to improve LTR outcomes.

Main Methods:

• A comprehensive literature review was conducted from January 1, 1990, to March 17, 2021.
• An expert panel synthesized existing evidence on cardiac disease in LTRs.
• Recommendations were developed based on the reviewed literature and clinical expertise.

Main Results:

• Optimizing the management of metabolic syndrome and its components is crucial for LTRs.
• Newer diabetes medications, such as sodium-glucose cotransporter-2 inhibitors, show potential cardioprotective benefits in LTRs.
• Individualized, multidisciplinary management tailored to the patient's cardiometabolic risk profile is essential.

Conclusions:

• Effective management of cardiac diseases in LTRs requires a proactive, multidisciplinary strategy.
• Addressing metabolic syndrome and leveraging novel pharmacotherapies can mitigate cardiac risks.
• Further research is needed to address identified knowledge gaps and enhance long-term outcomes for LTRs.