Hepatic dysfunction may occur as hypoxic hepatitis [118] in patients with acute HF or more commonly as ‘cardiohepatic syndrome’ in the setting of congestive HF [119–121]. Liver dysfunction is a predictor of poor outcome in patients with advanced HF requiring LT-MCS [41]. However, the liver has outstanding regeneration potential, which may occur after LT-MCS implantation [59, 63, 122–126]. Preoperative liver dysfunction influences the levels of circulating coagulation proteins and affects postoperative blood product requirements [127].