Appraising cardiac dysfunction in liver transplantation: an ongoing challenge

Authors

  • Ahmed Zaky,

    Corresponding author
    1. Department of Anesthesiology and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
    • Correspondence

      Ahmed Zaky, MD, MPH

      Assistant Professor of Anesthesiology and Critical Care Medicine, University of Alabama at Birmingham,

      826 Jefferson Tower,

      625 19th St. South, Birmingham, AL, USA

      Tel: 205 934 5272

      Fax: 205 934 2564

      e-mail: azaky@uab.edu

    Search for more papers by this author
  • Karim Bendjelid

    1. Department of Anaesthesiology, Pharmacology and Intensive Care, Geneva, Switzerland
    Search for more papers by this author

Absract

End-stage liver disease (ESLD) is a multisystemic disease that adversely and mutually aggravates other organs such as the heart. Cardiac dysfunction in ESLD encompasses a spectrum of disease that could be aggravated, precipitated or be occurring hand-in-hand with coexisting aetiological factors precipitating cirrhosis. Additionally and more complexly, liver transplantation, the curative modality of ESLD, is responsible for additional intra- and postoperative short- and long-term cardiac morbidity. The phenotypic distinction of the different forms of cardiac dysfunction in ESLD albeit important prognostically and therapeutically is not allowed by the current societal recommendations, due to conceptual, and methodological limitations in the appraisal of cardiac function and structure in ESLD and in designing studies that are based on this appraisal. This review comprehensively discusses the spectrum of cardiac dysfunction in ESLD, discusses the limitations of the current appraisal of cardiac dysfunction in ESLD, and proposes a hypothetical approach for studying cardiac dysfunction in liver transplant candidates.

Ancillary