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World J Transplant. Dec 18, 2025; 15(4): 102995
Published online Dec 18, 2025. doi: 10.5500/wjt.v15.i4.102995
Aortic stenosis in cirrhosis: Pathophysiology and management in the context of liver transplantation
Brian Osorio, Sam W Fox, Katherine M Cooper, Sahas Chandragiri, Amir F Mohani, Deepika Devuni
Brian Osorio, Sahas Chandragiri, Department of Medicine, Brown University, Providence, RI 02903, United States
Sam W Fox, Katherine M Cooper, Deepika Devuni, Department of Medicine, UMass Chan Medical School, Worcester, MA 01655, United States
Amir F Mohani, Department of Medicine, UMass Chan Medical School-Baystate, Springfield, MA 01103, United States
Author contributions: Osorio B, Fox SW, Cooper KM, Chandragiri S, Mohani AF, and Devuni D contributed to conceptualization, writing, and editing; Cooper KM, Mohani AF, and Devuni D contributed to supervision.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Katherine M Cooper, MD, Department of Medicine, UMass Chan Medical School, 55 Lake Avenue North, Worcester, MA 01655, United States. katherine.cooper@umassmed.edu
Received: November 5, 2024
Revised: March 28, 2025
Accepted: April 28, 2025
Published online: December 18, 2025
Processing time: 380 Days and 2.4 Hours
Core Tip

Core Tip: Managing aortic stenosis in patients with cirrhosis presents unique challenges due to overlapping pathophysiology and high surgical risks, particularly for those undergoing liver transplantation. Transcatheter aortic valve replacement is emerging as the preferred intervention for high-risk cirrhotic patients, offering improved short-term outcomes and the potential to serve as a bridge to liver transplantation. Current perioperative risk scoring systems inadequately account for liver disease, highlighting the need for specialized guidelines and a multidisciplinary approach to optimize outcomes in this complex patient population.