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KMID : 0356920180710020085
Korean Journal of Anesthesiology
2018 Volume.71 No. 2 p.85 ~ p.91
Cardiovascular dysfunction and liver transplantation
Kwon Hye-Mee

Hwang Gyu-Sam
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
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