Cardiovascular assessment before liver transplantation

Cardiovascular diseases are one of the main causes of mortality after liver transplant (LT). Assessment for these diseases is instrumental in candidate selection to optimize posttransplant survival. Coronary artery disease (CAD) is prevalent among LT candidates reflecting the burden of traditional cardiovascular risk factors, especially with increasing proportion of nonalcoholic steatohepatitis patients. The optimal approach for CAD screening needs further investigation. Medical or interventional management of CAD should be promptly applied in order to reduce peri- and post-LT mortality. Atrial fibrillation pre-LT often reflects underlying cardiac pathology and should prompt further investigation. The initiation and choice of anticoagulation should be individualized. Assessment for cirrhotic cardiomyopathy should be implemented in the echocardiographic evaluation pretransplant.