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Severe Cardiovascular Complications Following Liver Transplantation in Patients With Iron Overload

June-Wha Rhee1,2, Sophia Zhang1, Amy Gallo3

  • 1Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA.

JACC. Case Reports
|June 9, 2022
PubMed

Insights

Liver transplantation carries a high risk of heart failure in patients with cardiac iron overload. A pragmatic approach is crucial for assessing cardiovascular risk in these liver transplant candidates.

Area of Science:

  • Cardiology
  • Hepatology
  • Transplantation Medicine

Background:

  • Cardiac iron overload is a significant concern in patients undergoing liver transplantation.
  • Assessing cardiovascular risk is critical for patient management and outcomes.

Observation:

  • Four cases highlight the severe risk of heart failure and cardiogenic shock in liver transplant recipients with cardiac iron overload.
  • These cases underscore the need for careful pre-transplant cardiovascular evaluation.

Findings:

  • Cardiac iron overload poses a substantial threat to cardiovascular stability during and after liver transplantation.
  • Early identification and management of cardiac complications are essential.

Implications:

  • A structured approach to cardiovascular risk assessment is necessary for liver transplant candidates with cardiac iron overload.
  • Optimizing cardiac health pre-transplantation can improve outcomes and reduce perioperative complications.

Keywords:
CMR, cardiac magnetic resonanceESLD, end-stage liver diseaseHF, heart failureLT, liver transplantationLV, left ventricularLVEF, left ventricular ejection fractioncardiac iron overloadcardiac magnetic resonancecardiovascular complicationsliver transplantationpreoperative cardiovascular risk assessment

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