Pre-transplant cardiac evaluation in liver transplant recipients.

Liver transplantation (LT) remains the ultimate curative treatment for decompensated cirrhosis and specific hepatobiliary cancers. Adverse cardiac events significantly contribute to post-LT morbidity and mortality, and the prevalence of cardiovascular comorbidities is rising in this new era of steatotic-predominant liver disease. Therefore, successful LT recipient selection requires accurate and timely assessment of pre-LT cardiac risk. This review provides updated data on the prevalence of certain cardiac pathologies in the LT candidate population, examines how these conditions affect waitlist survival and post-LT outcomes, explores advances in screening diagnostics for better cardiac risk stratification, and discusses initial clinical management strategies to mitigate cardiac risk.