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Case Reports
. 2022 Jun 1;4(11):677-681.
doi: 10.1016/j.jaccas.2021.12.012.

Severe Cardiovascular Complications Following Liver Transplantation in Patients With Iron Overload

June-Wha Rhee  1   2 , Sophia Zhang  1 , Amy Gallo  3 , Aijaz Ahmed  4 , Masataka Kawana  1
Affiliations
Case Reports

Severe Cardiovascular Complications Following Liver Transplantation in Patients With Iron Overload

June-Wha Rhee et al. JACC Case Rep. .

Abstract

We report 4 cases of our institutional experience with liver transplantation that illustrate the high risk of heart failure and cardiogenic shock in the setting of cardiac iron overload. We then discuss a pragmatic approach to assess the cardiovascular risk in liver transplantation candidates with cardiac iron overload. (Level of Difficulty: Advanced.).

Keywords: CMR, cardiac magnetic resonance; ESLD, end-stage liver disease; HF, heart failure; LT, liver transplantation; LV, left ventricular; LVEF, left ventricular ejection fraction; cardiac iron overload; cardiac magnetic resonance; cardiovascular complications; liver transplantation; preoperative cardiovascular risk assessment.

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Conflict of interest statement

The authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

None
Graphical abstract
Figure 1
Figure 1
Cardiovascular Complications of Liver Transplantation and Proposed Risk Assessment Strategy (A) Pathophysiology of cardiovascular dysfunction in patients with end-stage liver disease and cardiovascular changes following orthotopic liver transplant. (B) Cardiovascular risk assessment algorithm on the basis of iron overload status. #A joint evaluation between the liver transplant and heart transplant teams should be considered for possible combined heart-liver transplantation; if the decision is to proceed with liver transplantation only, close coordination with cardiology is warranted, with a mechanical circulatory support team on standby at the time of liver transplantation. Created using BioRender. Cath = catheterization; LVEF = left ventricular ejection fraction; MRI = magnetic resonance imaging; RAA = renin-angiotensin-aldosterone.
See this image and copyright information in PMC

References

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