Evaluation of recipients with significant comorbidity - Patients with cardiovascular disease

Area of Science:

• Cardiology
• Hepatology
• Transplant Surgery

Background:

• Liver transplantation (LT) is a critical treatment for decompensated liver disease.
• Rising rates of obesity, type 2 diabetes, and non-alcoholic fatty liver disease increase cardiovascular disease (CVD) risk in LT candidates.
• CVD is a leading cause of morbidity and mortality post-LT, necessitating robust pre-transplant cardiovascular assessment.

Purpose of the Study:

• To review current evidence on cardiovascular evaluation for liver transplant candidates.
• To highlight key cardiovascular conditions relevant to LT recipients, including ischemic heart disease, arrhythmias, valvular heart disease, and cardiomyopathies.

Main Methods:

• Standard pre-LT work-up includes electrocardiogram, echocardiography, and cardiopulmonary function assessment.
• Further investigations, such as coronary computed tomography angiography, are guided by baseline findings and cardiovascular risk factors.
• A multidisciplinary approach involving anesthesiologists, cardiologists, hepatologists, and transplant surgeons is essential.

Main Results:

• The review synthesizes the latest evidence on pre-LT cardiovascular assessment strategies.
• It emphasizes the importance of identifying and managing prevalent cardiovascular conditions in LT candidates.
• The findings underscore the necessity of a tailored diagnostic approach based on individual patient risk profiles.

Conclusions:

• Thorough pre-LT cardiovascular evaluation is crucial for mitigating post-transplant complications.
• A multidisciplinary team approach ensures comprehensive assessment and management of cardiovascular risks in LT candidates.
• Optimizing cardiovascular health pre-transplant can significantly improve patient outcomes and survival rates.