Preoperative Cardiological Assessment in Liver Transplant Candidates

Larissa Roberta Negrão; Luís Gustavo Ramos Raupp Pereira; Rafael Borislav Beal Welfer; Laura Mohr; Micael Guzzon; Paulo Roberto Reichert; Rogério Tadeu Tumelero

Autores

Larissa Roberta Negrão Universidade de Pernambuco – Faculdade de Ciências Médicas – Departamento de Introdução a Metodologia da Pesquisa – Recife (PE) – Brasil. https://orcid.org/0000-0003-1676-1018
Luís Gustavo Ramos Raupp Pereira Universidade de Pernambuco – Faculdade de Ciências Médicas – Departamento de Introdução a Metodologia da Pesquisa – Recife (PE) – Brasil. https://orcid.org/0000-0003-0194-6167
Rafael Borislav Beal Welfer Universidade de Pernambuco – Faculdade de Ciências Médicas – Departamento de Introdução a Metodologia da Pesquisa – Recife (PE) – Brasil. https://orcid.org/0000-0002-4633-4538
Laura Mohr Universidade de Pernambuco – Faculdade de Ciências Médicas – Departamento de Introdução a Metodologia da Pesquisa – Recife (PE) – Brasil. https://orcid.org/0000-0003-0555-7046
Micael Guzzon Universidade de Pernambuco – Faculdade de Ciências Médicas – Departamento de Introdução a Metodologia da Pesquisa – Recife (PE) – Brasil. https://orcid.org/0000-0002-7684-3368
Paulo Roberto Reichert Universidade de Pernambuco – Faculdade de Ciências Médicas – Departamento de Introdução a Metodologia da Pesquisa – Recife (PE) – Brasil. https://orcid.org/0000-0002-2909-7593
Rogério Tadeu Tumelero Universidade de Pernambuco – Faculdade de Ciências Médicas – Departamento de Introdução a Metodologia da Pesquisa – Recife (PE) – Brasil. https://orcid.org/0009-0000-9576-9557

Palavras-chave:

Transplante de Fígado, Doenças Cardíacas, Período Pré-Operatório

Resumo

Objetivos: O objetivo deste estudo é reunir informações da literatura sobre a avaliação cardiológica em pacientes candidatos ao transplante de fígado (TF) e apresentar os principais achados e evidências relacionadas a esse tema. Métodos: Este artigo reúne as evidências disponíveis na literatura acerca da importância da avaliação cardiológica em pacientes candidatos ao TF para aprimorar a seleção e o cuidado desses pacientes. Para a elaboração deste artigo de revisão, foram consultados e selecionados artigos publicados em bases científicas nas plataformas PubMed/MEDLINE, LILACS e SciELO. Resultados: O escore de doença arterial coronariana (DAC) em TF apresenta alta sensibilidade para predizer o risco de DAC em pacientes candidatos ao TF e deve ser utilizado sempre que possível. Atualmente, a angiografia coronária permanece como padrão-ouro para a avaliação da DAC nesses pacientes. Caso este exame não seja indicado, a angiotomografia computadorizada multidetectores pode ser utilizada como alternativa, pois permite classificar o grau da lesão aterosclerótica, embora seja menos sensível. A ecocardiografia sob estresse farmacológico com dobutamina pode auxiliar na detecção de isquemia miocárdica e, em especial, na investigação de insuficiência cardíaca e outras cardiomiopatias, já que sua sensibilidade para DAC é inferior à de outros exames. Conclusão: O TF é o segundo procedimento de transplante de vísceras maciças mais realizado no mundo, ficando atrás apenas do transplante renal. Por se tratar de um procedimento complexo, algumas complicações são possíveis, sendo as cardiovasculares a principal causa de óbito não relacionado ao enxerto e a terceira causa geral de morte entre os pacientes submetidos ao TF. Considerando a alta prevalência das doenças cardiovasculares e sua apresentação como uma das principais causas de morte no mundo, é fundamental que os candidatos ao TF sejam submetidos a uma triagem rigorosa antes da realização do transplante.

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