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Updated: May 17, 2026
Reduced Complications after Arterial Reconnection in a Rat Model of Orthotopic Liver Transplantation
Published on: November 7, 2020
Liver transplantation outcome in patients with angiographically proven coronary artery disease: a multi-institutional
C Wray1, J C Scovotti, J Tobis
1Department of Anesthesiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA. cwray@mednet.ucla.edu
Insights
Coronary artery disease (CAD) does not significantly impact liver transplant (LT) survival when treated before surgery. This multicenter study found similar outcomes for LT recipients with and without obstructive CAD.
Area of Science:
- Cardiology
- Hepatology
- Transplantation Medicine
Background:
- Increasing age and prevalence of coronary artery disease (CAD) in liver transplant (LT) recipients pose challenges to post-transplant outcomes.
- Limited multicenter data exist on the impact of pre-existing CAD on LT success.
Purpose of the Study:
- To investigate the association between angiographically proven obstructive CAD and post-LT survival in a multicenter cohort.
- To evaluate survival differences based on CAD severity (moderate vs. severe) in LT recipients.
Main Methods:
- Historical cohort study of adult LT recipients undergoing pre-transplant angiography at seven institutions over 12 years.
- Data collected included demographics, donor/recipient risk factors, follow-up duration, and presence/severity of obstructive CAD (≥50% stenosis).
- Statistical analysis using adjusted hazard ratios (HR) to compare survival between CAD groups.
Main Results:
- Obstructive CAD was identified in 151 of 630 (24%) LT recipients.
- Overall patient survival was similar between patients with obstructive CAD (CAD+) and without (CAD-) (adjusted HR 1.13, p=0.493).
- Survival rates were also comparable for severe CAD (>70% stenosis) and moderate CAD (50-70% stenosis) subgroups compared to the CAD- group.
Conclusions:
- Current CAD management strategies prior to liver transplantation result in comparable post-LT survival, irrespective of obstructive CAD presence.
- Pre-transplant CAD, even when severe, does not appear to be an independent negative predictor of LT outcomes with appropriate treatment.
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.
