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Influence of coronary artery disease on outcomes after liver transplantation

D A Diedrich1, J Y Findlay, B A Harrison

  • 1Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota 55905, USA.

Transplantation Proceedings
|December 23, 2008
PubMed

Insights

Patients with coronary artery disease (CAD) undergoing liver transplantation (OLT) still face higher mortality and cardiovascular morbidity. Outcomes have improved but remain worse than patients without CAD, indicating ongoing risks in this high-risk group.

Area of Science:

  • Cardiology
  • Hepatology
  • Transplantation Medicine

Background:

  • Coronary artery disease (CAD) patients undergoing liver transplantation (OLT) are a recognized high-risk population.
  • Significant advancements in CAD management and OLT selection criteria have occurred since initial risk identification.

Purpose of the Study:

  • To compare outcomes of OLT in patients with known CAD versus a matched control group without CAD.
  • To assess the impact of current management and selection strategies on CAD patient outcomes post-OLT.

Main Methods:

  • Retrospective analysis of 42 patients with known CAD who underwent OLT.
  • Comparison with a matched control group of 42 patients without CAD (matched for gender, age, primary liver disease).

Main Results:

  • Higher 1-year and 3-year mortality rates in the CAD group (11 vs 3 at 3 years; P < .05).
  • Increased incidence of new cardiovascular morbidity at 1 and 3 years in the CAD group (16 vs 4 at 3 years; P < .05).
  • Observed 3-year mortality (26%) is lower than historical reports (50%) but still elevated compared to controls.

Conclusions:

  • Outcomes for OLT patients with CAD have improved but remain suboptimal compared to non-CAD patients.
  • Current management and selection strategies mitigate but do not eliminate the increased risks associated with CAD in OLT recipients.

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