Combined cardiac surgery and liver transplantation: three decades of worldwide results.

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. CONCLUSION 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.