Tandon Manish, Karna Sunaina Tejpal, Pandey Chandra Kant, Chaturvedi Ravindra
Institute of Liver and Biliary Sciences, New Delhi 110070, India.
World J Hepatol. 2017 Nov 28;9(33):1253-1260. doi: 10.4254/wjh.v9.i33.1253.
Heart failure (HF) following liver transplant (LT) surgery is a distinct clinical entity with high mortality. It is known to occur in absence of obvious risk factors. No preoperative workup including electrocardiogram, echocardiography at rest and on stress, reasonably prognosticates the risk. In patients of chronic liver disease, cirrhotic cardiomyopathy, alcoholic cardiomyopathy, and stress induced cardiomyopathy have each been implicated as a cause for HF after LT. However distinguishing one etiology from another not only is difficult, several etiologies may possibly coexist in a given patient. Diagnostic dilemma is further compounded by the fact that presentation and management of HF irrespective of the possible underlying cause, remains the same. In this case series, 6 cases are presented and in the light of existing literature modification in the preoperative workup are suggested.
肝移植（LT）手术后发生的心力衰竭（HF）是一种死亡率很高的独特临床实体。已知其在没有明显危险因素的情况下发生。包括心电图、静息和负荷超声心动图在内的术前检查均无法合理预测这种风险。在慢性肝病患者中，肝硬化性心肌病、酒精性心肌病和应激性心肌病都被认为是肝移植后发生心力衰竭的原因。然而，区分一种病因与另一种病因不仅困难，而且在特定患者中几种病因可能同时存在。由于无论潜在病因如何，心力衰竭的表现和管理都相同，这进一步加剧了诊断困境。在本病例系列中，报告了6例病例，并根据现有文献对术前检查提出了改进建议。
