title: Pre operative cardio pulmonary assessment of the liver transplant candidate.
abstract: Given the severe shortage of liver donors, a carefully evaluation and selection of patients who are likely to obtain a significant survival benefit from liver transplantation (LT) is imperative in order to attain successful outcomes. Cardiovascular and respiratory events remain one of the leading causes of non-graft-related death in LT. A variety of pre-existing cardiac and pulmonary disorders are commonly identified in LT recipients, more so than in the general population. Uncertainties regarding the optimal assessment of cardiovascular and respiratory function in potential transplant candidates have produced a wide variation in the clinical care of tjis population. There is still no consensus on which assessment algorithm confers the best outcomes. Once the diagnosis has been established, the prognosis should be estimated for risk stratification and to confirm the candidacy for LT. Additionally, the challenge remains in knowing how cardiac or respiratory derangements in candidates affect the long-term outcome after LT and which is the magnitude of risk that we as physicians are willing to accept. This article discusses the cardiac and pulmonary aspects of liver disease that may impact recipient selection. Relevant literature focused upon the most common entities in this field is presented in this review.<br />
authors.affiliation: Anesthesiology Department, Liver Transplant Unit, Hospital Clínic, University of Barcelona, Barcelona, Spain. gmartin@clinic.ub.es
authors.forename: Graciela
authors.initials: G
authors.lastname: Martinez-Palli
authors.forename: Andrés
authors.initials: A
authors.lastname: Cárdenas
mesh_terms: D000465:Algorithms; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000401:mortality; D015897:Comorbidity; D003935:Diagnostic Techniques, Cardiovascular; D003948:Diagnostic Techniques, Respiratory System; D006801:Humans; D008107:Liver Diseases / Q000453:epidemiology / Q000401:mortality / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects / Q000401:mortality; D008171:Lung Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000401:mortality; D018579:Patient Selection; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors