Copyright ©The Author(s) 2022.
World J Transplant. Jul 18, 2022; 12(7): 142-156
Published online Jul 18, 2022. doi: 10.5500/wjt.v12.i7.142
Table 1 Preoperative assessment of common cardiac diseases and relationship with liver transplant outcomes

During transplant
Coronary artery diseasePrevalence 2%-38%. Screening: DSE (high NPV), SPECT myocardial perfusion, conventional coronary angiography (gold standard)Cumulative 3-yr post-LT MACE incidence: 37.5%. All-cause mortality: 13%
Cirrhotic cardiomyopathyPrevalence 40%-50%. TTE is the preferred method for the diagnosis of systolic or diastolic dysfunction preoperatively23% abnormal cardiac responsePretransplant diastolic dysfunction increase the risk for acute graft rejection or failure, and all-cause mortality
Valvular heart disease27.5% with cardiac valve dysfunction. Routine TTE screening is recommended prior to LTSevere aortic stenosis associated with 31% risk of perioperative complicationsPretransplant AV replacement or AS increase the likelihood for significant cardiac complications 1-3 yr post-LT
Portopulmonary hypertensionPrevalence 5%-8.5%. Preoperative screening with TTE is recommended to all LT candidates. Patients with RVSP > 45 mm Hg needs confirmation with RHCMPAP > 50 mm Hg: 100% mortality. MPAP 35-50 mm Hg: Increased morbidity and mortality. MPAP < 35 mm Hg and MPAP > 35 mm Hg due to volume overload or hyperdynamic state: No increase in mortality
Conduction abnormalitiesRoutine ECG should be performed in all LT candidates independently of a cardiac abnormality historyAF is the most common MACE in the first 90 d post-transplant (-43%). AF is an independent risk factor for MACE 30- and 90-d after LT
QTc prolongationCommon ECG finding in ESLD patients with CCM; no sex-based differences exist as in general population. Reversible causes of QTc prolongation should be identified and corrected preoperativelyConflicting data exist regarding QTc prolongation as an independent predictor of mortality and its reversibility post-LT