International Liver Transplantation Society/Liver Intensive Care Group of Europe guidelines for cardiovascular assessment before liver transplantation

Cardiovascular disease is the leading cause of morbidity and mortality among liver transplantation (LT) recipients. A panel of 24 experts from the International Liver Transplantation Society and the Liver Intensive Care Group of Europe convened to develop guidelines for preoperative cardiovascular assessment of LT candidates. The panel identified 7 areas required for standard cardiovascular preoperative assessment. Quality of evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation approach. Strong or conditional recommendations were provided according to the overall level of evidence. Good practice statements were provided for recommendations with only low to very low quality of evidence. After 2 rounds of deliberations, the panel provided 7 strong (high level of evidence, grade 1 ±) recommendations and 6 conditional (low level of evidence, grade 2 ±) recommendations for cardiovascular evaluation before LT. Seven recommendations were based on good practice statements because of a very low level of evidence. Agreement between panelists was reached for 100% of recommendations. Several recommendations are made to improve a candidate's cardiovascular assessment before LT.

Published by American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 2026. The guideline itself is at the source linked here.

doi.org/10.1016/j.ajt.2025.09.020