Diseases known to affect both the heart and liver include a variety of infectious, autoimmune, and metabolic disorders, as well as toxins: most commonly alcohol. As damage to both the heart and liver progresses, transplantation is a reasonable therapeutic option. Heart failure patients with underlying congestive hepatopathy receiving cardiac transplant have demonstrated improved liver enzyme levels posttransplant. Patients with severe end-stage liver disease requiring a liver transplant must undergo careful preoperative evaluation as surgical stress exposes the myocardium to high levels of catecholamines. Clinicians must consider both cardiac and hepatic complications when evaluating heart failure, cirrhosis, and nonalcoholic fatty liver disease. In Part 2 of this review, we discuss new noninvasive techniques for assessing liver fibrosis in the preoperative stage. Both serum and radiologic studies, such as transient elastography, have begun to take the place of liver biopsy due to their decreased morbidity. Last, we explore the current research examining the benefit of combined heart-liver transplant, although more longitudinal outcome studies are needed.

已知影响心脏和肝脏的疾病包括各种传染性、自身免疫性和代谢性疾病，以及毒素：最常见的是酒精。随着心脏和肝脏损伤的进展，移植是一种合理的治疗选择。患有潜在充血性肝病的心力衰竭患者接受心脏移植后，肝酶水平有所改善。需要肝移植的严重终末期肝病患者必须接受仔细的术前评估，因为手术应激会使心肌暴露于高水平的儿茶酚胺。临床医生在评估心力衰竭、肝硬化和非酒精性脂肪肝时必须考虑心脏和肝脏并发症。在本综述的第二部分中，我们讨论了术前阶段评估肝纤维化的新无创技术。由于发病率降低，血清和放射学研究（例如瞬时弹性成像）已开始取代肝活检。最后，我们探讨了当前研究心肝联合移植的益处，尽管还需要更多的纵向结果研究。