The heart in liver transplantation Cristina Ripoll, Raquel Yotti, Javier Bermejo, Rafael Bañares  Journal of Hepatology  Volume 54, Issue 4, Pages 810-822 (April 2011) DOI: 10.1016/j.jhep.2010.11.003 Copyright © 2010 European Association for the Study of the Liver Terms and Conditions

Fig. 1 Diagram of pathophysiology of portal hypertension. The increase in portal pressure is defined by Ohm’s law, that states that pressure depends on resistance and flow. In cirrhosis there is an initial increase in intrahepatic resistance. This increase in intrahepatic resistance leads to splanchnic vasodilation which in turn leads to central hypovolemia and activation of vasoactive mechanisms that increase cardiac output and kidney sodium retention. This leads to an increase in portal venous flow. The combination of both mechanisms leads to an increase in portal pressure. Furthermore, increased intrahepatic resistance also leads to an independent increase in kidney sodium retention and further increases portal venous flow. Journal of Hepatology 2011 54, 810-822DOI: (10.1016/j.jhep.2010.11.003) Copyright © 2010 European Association for the Study of the Liver Terms and Conditions

Fig. 2 Algorithm for pretransplant cardiac evaluation, taking into account the most frequently identified problem in LT candidates. Most centers perform EKG and echocardiography on a routine basis. Screening of patients with risk factors for CAD is also recommended. According to the findings in these initial examinations, further tests will be performed. Journal of Hepatology 2011 54, 810-822DOI: (10.1016/j.jhep.2010.11.003) Copyright © 2010 European Association for the Study of the Liver Terms and Conditions

Journal of Hepatology 2011 54, 810-822DOI: (10. 1016/j. jhep. 2010. 11 Copyright © 2010 European Association for the Study of the Liver Terms and Conditions