Korean J Anesthesiol.  2018 Apr;71(2):85-91. 10.4097/kjae.2018.71.2.85.

Cardiovascular dysfunction and liver transplantation

• Kwon HM
• Hwang GS

• KMID: 2411215
• DOI: http://doi.org/10.4097/kjae.2018.71.2.85

Abstract

Cardiovascular complications have emerged as the leading cause of death after liver transplantation, particularly among those with advanced liver cirrhosis. Therefore, a thorough and accurate cardiovascular evaluation with clear comprehension of cirrhotic cardiomyopathy is recommended for optimal anesthetic management. However, cirrhotic patients manifest cardiac dysfunction concomitant with pronounced systemic hemodynamic changes, characterized by hyperdynamic circulation such as increased cardiac output, high heart rate, and decreased systemic vascular resistance. These unique features mask significant manifestations of cardiac dysfunction at rest, which makes it difficult to accurately evaluate cardiovascular status. In this review, we have summarized the current knowledge of heart and liver interactions, focusing on the usefulness and limitations of cardiac evaluation tools for identifying high-risk patients.

Keyword

Autonomic nervous system; Cardiovascular dysfunction; Coronary artery disease; Echocardiography; Liver transplantation; Ventriculo-arterial coupling

MeSH Terms

Autonomic Nervous System
Cardiac Output, High
Cardiomyopathies
Cause of Death
Comprehension
Coronary Artery Disease
Echocardiography
Heart
Heart Rate
Hemodynamics
Humans
Liver Cirrhosis
Liver Transplantation*
Liver*
Masks
Vascular Resistance