Preoperative evaluation prior to listing for orthotopic liver transplantation (LT) requires a careful multidisciplinary approach with specialized teams including surgeons, hepatologists and anesthesiologists in order to improve short- and long-term clinical outcomes. Due to inadequate supply of donor organs and changing demographics, patients listed for LT have become older, sicker and share more comorbidities. As cardiovascular events are the leading cause for early mortality precise evaluation of risk factors is mandatory. This review focuses on the detection and management of coronary artery disease, cirrhotic cardiomyopathy, portopulmonary hypertension and hepatopulmonary syndrome in patients awaiting LT. Further insights are being given into scoring systems, patients with Acute-on-chronic-liver-failure (ACLF), frailty, NASH cirrhosis and into psychologic evaluation of patients with substance abuse.
Keyphrases
- cardiovascular events
- coronary artery disease
- risk factors
- end stage renal disease
- newly diagnosed
- ejection fraction
- liver failure
- heart failure
- cardiovascular disease
- prognostic factors
- hepatitis b virus
- patients undergoing
- palliative care
- type diabetes
- physical activity
- community dwelling
- percutaneous coronary intervention
- drug induced
- patient reported