title: Combined cardiac surgery and liver transplantation: three decades of worldwide results.
abstract: BACKGROUND
  Patients with end-stage-liver-disease (ESLD) require orthotopic liver transplantation (OLT) as treatment. However, cirrhotic cardiomyopathy can be clinically revealed during OLT, with the possible development of a transient overt congestive heart failure. A number of patients require a combined procedure of liver transplantation and heart surgery, which includes heart transplantation, aortic valve replacement or coronary artery bypass grafting. Indications for combined liver-heart transplantation include heart failure with associated cardiac cirrhosis, familial amyloidosis, familial hypercholesterolemia and hemochromatosis, and homozygous β-thalassemia. METHODS/RESULTS. We performed a thorough research of Pubmed/ Medline, gathering and discussing data concerning this clinical condition and its treatment.
  
  
  CONCLUSIONS
  In patients with end-stage liver disease, who are unable to tolerate an OLT post-operatively due to cardiac dysfunction, combined cardiac surgery and OLT appears to have certain advantages.
authors.affiliation: Department of Transplant Surgery, Medical School, Aristotle University and Hippokration General Hospital, Thessaloniki, Greece. alexgiakoustidis@gmail.com
authors.forename: Alexandros
authors.initials: A
authors.lastname: Giakoustidis
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Cherian
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Antoniadis
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Giakoustidis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001024:Aortic Valve Stenosis / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D009202:Cardiomyopathies / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery*; D058625:End Stage Liver Disease / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D016027:Heart Transplantation; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult