Abstract
Cardiac diseases are one of the most common causes of morbidity and mortality following liver transplantation (LT). Prior studies have shown that cardiac diseases affect close to one-third of liver transplant recipients (LTRs) long term and that their incidence has been on the rise. This rise is expected to continue as more patients with advanced age and/or non-alcoholic steatohepatitis undergo LT. In view of the increasing disease burden, a multidisciplinary initiative was developed to critically review the existing literature (between January 1, 1990 and March 17, 2021) surrounding epidemiology, risk assessment, and risk mitigation of coronary heart disease, arrhythmia, heart failure, and valvular heart disease and formulate practice-based recommendations accordingly. In this review, the expert panel emphasizes the importance of optimizing management of metabolic syndrome and its components in LTRs and highlights the cardioprotective potential for the newer diabetes medications (e.g., sodium glucose transporter-2 inhibitors) in this high-risk population. Tailoring the multidisciplinary management of cardiac diseases in LTRs to the cardiometabolic risk profile of the individual patient is critical. The review also outlines numerous knowledge gaps to pave the road for future research in this sphere with the ultimate goal of improving clinical outcomes.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 2740-2758 |
| Number of pages | 19 |
| Journal | American Journal of Transplantation |
| Volume | 22 |
| Issue number | 12 |
| DOIs | |
| State | Published - Dec 2022 |
Bibliographical note
Funding Information:L.B.V. is supported by the National Institutes of Health/National Heart, Lung, and Blood Institute grant number K23 HL136891
Funding Information:
B.E.F. is a consultant for W.L. Gore and Associates and Cook Medical. L.B.V. receives investigator‐initiated grant support from W.L. Gore and Associates, grant support from Intercept Pharmaceuticals, and grant support from AMRA Medical outside the scope of this work. All other authors declare no conflicts of interest.
Funding Information:
L.B.V. is supported by the National Institutes of Health/National Heart, Lung, and Blood Institute grant number K23 HL136891 The authors would like to thank (1) Ms. Dyanna Gregory of Northwestern University Feinberg School of Medicine, Division of Gastroenterology and Hepatology for her assistance in conducting the literature search, (2) American Society of Transplantation Liver and Intestine Community of Practice (LICOP) and Kidney and Pancreas Community of Practice (KPCOP) for their help with this initiative, and (3) the medical library staff at Weill Cornell College of Medicine for their help with the literature search.
Publisher Copyright:
Darshana M. Dadhania and Lisa B. VanWagner contributed equally.© 2022 The American Society of Transplantation and the American Society of Transplant Surgeons.
Keywords
- cardiac outcomes
- cirrhotic cardiomyopathy
- coronary artery disease
- liver transplant
