Safety of Cardiac Catheterization in Patients With End-Stage Liver Disease Awaiting Liver Transplantation

Sharma, M. L.; Yong, Celina M.; Majure, David T.; Zellner, Christian; Roberts, John P.; Bass, Nathan M.; Ports, Thomas A.; Yeghiazarians, Yerem; Gregoratos, Gabriel; Boyle, Andrew

doi:10.1016/j.amjcard.2008.10.037

Cited by 79 publications

(56 citation statements)

References 19 publications

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“…A population-based study in Denmark reported that liver disease is even associated with an increased risk of venous thrombosis compared to individuals without liver disease [71]. Similarly, cirrhotic patients are not Higher incidence of pseudoaneurysms and higher transfusion needs [34] Optimal preventive strategies remain to be defined. The increased risk of pseudoaneurysms suggests primary vascular problem Paracentesis…”

Section: Venous and Arterial Thrombosismentioning

confidence: 97%

Hemostasis and thrombosis in patients with liver disease: The ups and downs

Lisman

Caldwell

Burroughs

et al. 2010

Journal of Hepatology

318

236

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Section: Venous and Arterial Thrombosismentioning

confidence: 97%

Hemostasis and thrombosis in patients with liver disease: The ups and downs

Lisman

Caldwell

Burroughs

et al. 2010

Journal of Hepatology

318

236

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“…Coronary angiography is the gold standard technique to evaluate the presence of CAD. Although it has a low rate of complications [117] and can allow therapeutic management of the coronary lesion, it is an invasive test, that requires potentially nephrotoxic contrast media, and no information regarding the functional behavior of the coronary artery stenosis is obtained.…”

Section: Coronary Angiographymentioning

confidence: 99%

The heart in liver transplantation

Ripoll

Yotti

Bermejo

et al. 2011

Journal of Hepatology

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The heart and liver are organs that are closely related in both health and disease. Patients who undergo liver transplantation may suffer from heart disease that is: (a) related to the original cause of the liver disease such as hemochromatosis, (b) related to the liver disease itself, or (c) related to other associated conditions. Furthermore, liver transplantation is one of the most cardiovascular stressful events that a patient with cirrhosis may undergo. After liver transplantation, the progression of pre-existing or the development of new-onset cardiac disease may occur. This article reviews the relationship between the heart and liver transplantation in the pre-transplant, intra-operative, and post-transplant periods.

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“…Coronary angiography has been associated with an acceptable safety profile in LT candidates, who often have coagulopathies that render them at higher risk for bleeding complications, or concomitant renal dysfunction that increases the risk of contrast-induced nephropathy (46,47). A transradial approach to invasive angiography may prove useful in the ESLD population to further reduce bleeding complications (48).…”

Section: Coronary Artery Diseasementioning

confidence: 99%

Cardiovascular Risk Assessment of the Liver Transplant Candidate

Raval

Harinstein

Skaro

et al. 2011

Journal of the American College of Cardiology

228

174

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Liver transplantation (LT) candidates today are increasingly older, have greater medical acuity, and have more cardiovascular comorbidities than ever before. Steadily rising model for end-stage liver disease (MELD) scores at the time of transplant, resulting from high organ demand, reflect the escalating risk profiles of LT candidates. In addition to advanced age and the presence of comorbidities, there are specific cardiovascular responses in cirrhosis that can be detrimental to the LT candidate. Patients with cirrhosis requiring LT usually demonstrate increased cardiac output and a compromised ventricular response to stress, a condition termed cirrhotic cardiomyopathy. These cardiac disturbances are likely mediated by decreased beta-agonist transduction, increased circulating inflammatory mediators with cardiodepressant properties, and repolarization changes. Low systemic vascular resistance and bradycardia are also commonly seen in cirrhosis and can be aggravated by beta-blocker use. These physiologic changes all contribute to the potential for cardiovascular complications, particularly with the altered hemodynamic stresses that LT patients face in the immediate post-operative period. Post-transplant reperfusion may result in cardiac death due to a multitude of causes, including arrhythmia, acute heart failure, and myocardial infarction. Recognizing the hemodynamic challenges encountered by LT patients in the perioperative period and how these responses can be exacerbated by underlying cardiac pathology is critical in developing recommendations for the pre-operative risk assessment and management of these patients. The following provides a review of the cardiovascular challenges in LT candidates, as well as evidence-based recommendations for their evaluation and management.

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Safety of Cardiac Catheterization in Patients With End-Stage Liver Disease Awaiting Liver Transplantation

Cited by 79 publications

References 19 publications

Hemostasis and thrombosis in patients with liver disease: The ups and downs

Hemostasis and thrombosis in patients with liver disease: The ups and downs

The heart in liver transplantation

Cardiovascular Risk Assessment of the Liver Transplant Candidate

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