Efficacy of cardiological risk assessment in the preoperative period of liver transplantation

• Grant number: 24/20212-7
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: February 01, 2025
• End date: January 31, 2026
• Field of knowledge: Health Sciences - Medicine - Surgery
• Principal Investigator: Moacir Fernandes de Godoy
• Grantee: Gisele Brasil Nobre Chaves Rangel
• Host Institution: Faculdade de Medicina de São José do Rio Preto (FAMERP). Secretaria de Desenvolvimento Econômico (São Paulo - Estado). São José do Rio Preto , SP, Brazil

Abstract

"Brazil performs numerous surgical procedures daily, following safety protocols established by the Ministry of Health in partnership with the WHO. The preoperative consultation is essential to assess the patient's fitness, considering age, comorbidities, and risk factors. Surgeries can be minimally, moderately, or highly invasive, and the fitness assessment may change after medical intervention. The ASA system (American Society of Anesthesiology) is widely used to classify patients' health status, ranging from ASA1 (healthy patient) to ASA6 (brain death). In the preoperative evaluation, in addition to the consultation with the anesthesiologist, it is important to have a cardiologist's assessment due to the susceptibility to cardiovascular complications.Organ transplants, such as liver transplants, require rigorous evaluations considering the high complexity of the surgery and the patients' clinical condition. Survival after liver transplantation shows rates of 82% in the first year, progressively decreasing over the years. Cardiac complications, such as coronary artery disease and cardiomyopathy, are also important concerns in the postoperative period.The cardiological evaluation in the preoperative period of liver transplantation considers risk factors and specific exams, such as stress echocardiography and catheterization, in high-risk patients. However, there is no clear consensus on the best evaluation strategy, requiring professionals to adapt the exams to the individual needs of the patients.