Cardiovascular complications have emerged as the leading cause of early mortality following liver transplantation, highlighting the need for careful cardiovascular risk assessment in these patients.
Supports pre-transplant cardiovascular assessment in liver recipients; leaves open optimal risk mitigation strategies.
Liver transplantation (LT) is the only life-saving treatment option in patients with advanced liver disease. Deceased-donor LT is not frequent but is increasing in Asian countries. Because current liver allocation policies follow the severity principle wherein patients at highest risk for mortality receive top priority, anesthesiologists may face severely ill patients more frequently with deceased-donor LT than with living-donor LT. In this regard, with the outstanding surgical success of recent LT, cardiovascular complications have emerged as the leading cause of death after LT, particularly among those with advanced liver cirrhosis A large national cohort study of the Organ Procurement and Transplantation Network database also revealed that death from cardiovascular disease is the leading cause of early mortality (40%), followed by infection (28%), and graft failure (12%) Moreover, the numbers of patients receiving LT for non-alcoholic fatty liver disease [4] and alcoholic liver disease are increasing worldwide. Specifically, these patients are associated with one or more cardiovascular risk factors such as diabetes mellitus, hypertension, prior cardiovascular disease, left ventricular hypertrophy, age >60 years, smoking, hypertension, and dyslipidemia
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Kwon et al. (2018) studied this question.
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