Management of the liver transplant candidate with high cardiac risk: Multidisciplinary best practices and recommendations.

IF 4.7 2区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Liver Transplantation Pub Date : 2024-12-01 Epub Date: 2024-05-13 DOI:10.1097/LVT.0000000000000396
Giulia Pagano, Anoop N Koshy, Ryan Chadha, Lisa B VanWagner, Gonzalo Crespo
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Abstract

In a setting characterized by a growing prevalence of patients with alcohol-associated and metabolic dysfunction-associated steatotic liver diseases, coupled with an aging patient demographic, the incidence of cardiac comorbidities in liver transplant candidates is on the rise. These comorbidities not only pose barriers to transplant eligibility but also impact the intraoperative course and affect posttransplant outcomes. As such, there is a significant need to optimize the clinical management of these cardiac comorbidities. However, there is a scarcity of evidence regarding the best practices for managing cardiac comorbidities such as coronary and valvular heart diseases, arrhythmia, and cardiomyopathy in this population, both before and during transplant surgery. These conditions necessitate a coordinated and multidisciplinary approach to care. In this manuscript, we conduct a comprehensive review of the most recent evidence pertaining to the preoperative and intraoperative management of these cardiac comorbidities in liver transplant candidates. Our aim is to provide recommendations that improve and standardize their clinical care.

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高心脏风险肝移植候选者的管理:多学科最佳实践和建议。
酒精和代谢功能障碍相关的脂肪肝患者越来越多,再加上患者人口老龄化,肝移植候选者的心脏合并症发病率正在上升。这些合并症不仅对移植资格构成障碍,还会影响术中过程并影响移植后的预后。因此,亟需优化这些心脏合并症的临床管理。然而,关于在移植手术前和移植手术期间管理冠心病、瓣膜性心脏病、心律失常和心肌病等心脏合并症的最佳方法,目前还缺乏相关证据。这些疾病需要多学科的协调护理。在本手稿中,我们全面回顾了与肝移植候选者术前和术中管理这些心脏合并症相关的最新证据。我们的目的是为改善和规范临床护理提供建议。
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来源期刊
Liver Transplantation
Liver Transplantation 医学-外科
CiteScore
7.40
自引率
6.50%
发文量
254
审稿时长
3-8 weeks
期刊介绍: Since the first application of liver transplantation in a clinical situation was reported more than twenty years ago, there has been a great deal of growth in this field and more is anticipated. As an official publication of the AASLD, Liver Transplantation delivers current, peer-reviewed articles on liver transplantation, liver surgery, and chronic liver disease — the information necessary to keep abreast of this evolving specialty.
期刊最新文献
Management of the liver transplant candidate with high cardiac risk: Multidisciplinary best practices and recommendations. An international, multicenter, survey-based analysis of practice and management of acute liver failure. Utility of scores to predict alcohol use after liver transplant: Take them with a grain of salt. Intensive locoregional therapy before liver transplantation for colorectal cancer liver metastasis: A novel pretransplant protocol. Association of psychosocial risk factors and liver transplant evaluation outcomes in metabolic dysfunction-associated steatotic liver disease.
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