Management of patients with cardiopulmonary comorbidities awaiting liver transplantation.

Authors

Alex Liu, Manhal Izzy

Published in

Current opinion in organ transplantation. Sep 28, 2026. Epub Sep 28, 2026.

Abstract

The need for liver transplant continues to rise especially among those with metabolic dysfunction associated steatotic liver disease. Consequently, more transplant candidates have concurrent cardiopulmonary comorbidities. This review summarizes contemporary developments in cardiopulmonary care in liver transplant candidates.
Recent guidelines recommend noninvasive anatomic cardiovascular assessment before invasive coronary angiography for evaluation of coronary artery disease. Post-PCI DAPT can be used for as short as 1  month before waitlist activation. Practice-based guidance recommends echocardiographic surveillance on the waitlist especially with the evolving data on the impact of Cirrhotic Cardiomyopathy. Emerging evidence suggests that guideline directed medical therapy for heart disease is safe in patients with advanced liver disease. Updated portopulmonary hypertension guidelines emphasize revised screening and diagnostic thresholds, early initiation of medical therapy, and timely liver transplant evaluation.
Management of cardiopulmonary comorbidities in liver transplant candidates continues to advance yet remains nuanced requiring a multidisciplinary approach for optimal care.

PMID:
42788373
Bibliographic data and abstract were imported from PubMed on 25 Sep 2026.

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