Liver Transplantation Outcome in Patients With Angiographically Proven Coronary Artery Disease: A Multi‐Institutional Study |
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| Authors: | C. Wray J. C. Scovotti J. Tobis C. U. Niemann R. Planinsic A. Walia J. Findlay G. Wagener J. B. Cywinski D. Markovic C. Hughes A. Humar A. Olmos R. Sierra R. Busuttil R. H. Steadman |
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| Affiliation: | 1. Department of Anesthesiology, David Geffen School of Medicine at UCLA, , Los Angeles, CA;2. Department of Cardiology, David Geffen School of Medicine at UCLA, , Los Angeles, CA;3. Department of Anesthesia &Perioperative Care, University of California, , San Francisco, CA;4. Department of Surgery, University of California, , San Francisco, CA;5. Department of Anesthesiology, University of Pittsburgh Medical Center Presbyterian, , Pittsburgh, PA;6. Department of Anesthesiology and Perioperative Care, Vanderbilt University Medical Center, , Nashville, TN;7. Department of Anesthesiology, Mayo Clinic College of Medicine, , Rochester, MN;8. Department of Anesthesiology, Columbia University, , Columbia, NY;9. Department of General Anesthesiology, Cleveland Clinic, , Cleveland, OH;10. Department of Biomathematics, David Geffen School of Medicine at UCLA, , Los Angeles, CA;11. Department of Surgery, University of Pittsburgh Medical Center Presbyterian, , Pittsburgh, PA;12. Department of Surgery, David Geffen School of Medicine at UCLA, , Los Angeles, CA |
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| Abstract: | Over the last decade the age of liver transplant (LT) recipients and the likelihood of coronary artery disease (CAD) in this population have increased. There are no multicenter studies that have examined the impact of CAD on LT outcomes. In this historical cohort study, we identified adult LT recipients who underwent angiography prior to transplantation at seven institutions over a 12‐year period. For each patient we recorded demographic data, recipient and donor risk factors, duration of follow‐up, the presence of angiographically proven obstructive CAD (≥50% stenosis) and post‐LT survival. Obstructive CAD was present in 151 of 630 patients, the CAD(+) group. Nonobstructive CAD was found in 479 patients, the CAD(?) group. Patient survival was similar for the CAD(+) group (adjusted HR 1.13, CI = [0.79, 1.62], p = 0.493) compared to the CAD(?) group. The CAD(+) patients were further stratified into severe (CADsev, >70% stenosis, n = 96), and moderate CAD (CADmod, 50–70% stenosis, n = 55) groups. Survival for the CADsev (adjusted HR = 1.26, CI = [0.83, 1.91], p = 0.277) and CADmod (adjusted HR = 0.93, CI = [0.52, 1.66], p = 0.797) groups were similar to the CAD(?) group. We conclude that when current CAD treatment strategies are employed prior to transplant, post‐LT survival is not significantly different between patients with and without obstructive CAD. |
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| Keywords: | Coronary artery disease end‐stage liver disease liver transplantation mortality survival |
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