Intraoperative cardiac complications in liver transplantation: A comprehensive review of management strategies

Liver transplantation (LT) stands as the definitive treatment for end-stage liver disease (ESLD), but its perioperative management poses formidable challenges for anesthesiologists. Among the myriad complexities, cardiac actions emerge as pivotal determinants of mortality and overall outcomes. Understanding the multifaceted pathogenesis of ESLD and its profound impact on the circulatory system is paramount for effective anesthesia administration during LT. LT represents a dynamic process and constitutes one of the most taxing cardiovascular events for ESLD patients. The intricate nature of anesthesia management demands a precise multidisciplinary approach, requiring anesthesiologists to remain attuned to the swiftly evolving physiological, metabolic, hemodynamic, and bleeding-coagulation dynamics. Central to successful outcomes is a thorough preoperative evaluation and optimization of the cardiovascular system to mitigate potential intraoperative cardiac complications (ICCs). Through a meticulous review of the literatüre, our focus is to illuminate key ICCs encountered during the intraoperative phase of LT, offering insights into effective anesthesia management strategies.