Related Experiment Video
Updated: Mar 19, 2026
Reduced Complications after Arterial Reconnection in a Rat Model of Orthotopic Liver Transplantation
Published on: November 7, 2020
The predictors of post-transplant coronary events among liver transplant recipients
Mohammad U Malik1, Stuart D Russell2, Aliaksei Pustavoitau3
1Department of Gastroenterology/Hepatology, The Johns Hopkins School of Medicine, Rutland Avenue, Ross Research Building, Suite #918, Baltimore, MD, 21205, USA.
Insights
Liver transplant recipients experiencing coronary events have significantly reduced survival. Identifying these patients early through noninvasive screening can improve outcomes and minimize cardiac morbidity.
Area of Science:
- Cardiology
- Transplant Surgery
- Medical Diagnostics
Background:
- Cardiac morbidities are a significant concern during the peri- and post-liver transplant (LT) period, impacting long-term patient survival.
- Pre-transplant cardiac risk factors and screening methods are crucial for predicting post-transplant coronary events.
Purpose of the Study:
- To identify predictive factors for coronary events in patients following liver transplantation.
- To evaluate the effectiveness of noninvasive screening tools in identifying at-risk individuals.
Main Methods:
- Retrospective review of medical records for 146 liver transplant recipients (2009-2013).
- Analysis of pre-transplant cardiac risk factors and diagnostic tests for coronary artery disease.
- Comparison of patients with and without post-transplant coronary events.
Main Results:
- Age at liver transplant was a significant predictor of coronary events (OR 1.11, CI 1.01-1.20).
- Patients with coronary events had a 1-year survival rate of 47% compared to 94% in those without.
- Combined dobutamine stress echocardiogram and coronary artery calcium score showed 62.5% sensitivity and 66.7% specificity for predicting coronary events.
Conclusions:
- Liver transplant recipients with cardiac events exhibit limited survival.
- Noninvasive screening strategies, such as dobutamine stress echocardiogram and coronary artery calcium scoring, may offer a practical alternative to invasive cardiac workups.
- Improving screening strategies is essential to minimize cardiac morbidity after liver transplantation.
Background/Purpose:
Cardiac morbidities can occur during the peri- and post-liver transplant (LT) period, affecting the long-term survival. The purpose of this study was to identify the potential factors that predict a coronary event post-transplantation.
Methods:
Medical records of patients who underwent liver transplantation at Johns Hopkins Hospital between 2009 and 2013 were retrospectively reviewed. We looked at pre-liver transplant cardiac risk factors and the diagnostic tests utilized for coronary artery disease screening. Patients with and without post-liver transplant coronary events were compared.
Results:
There were a total of 146 patients with a mean age at LT of 55.3 years. The prevalence of hypertension, tobacco use and diabetes within the patient population was 61.6 % (n = 90), 39 % (n = 57) and 37.6 % (n = 55), respectively. There were 29 deaths and 30 coronary events over a median follow-up period of 1.75 years. Age at the time of liver transplant was predictive of coronary event (OR 1.11, CI 1.01-1.20). The 1-year survival in patients with a coronary event was 47 versus 94 % in patients without a coronary event. The combined use of a dobutamine stress echocardiogram and coronary artery calcium score predicted a coronary event with a sensitivity of 62.5 % and specificity of 66.7 %.
Conclusion:
In conclusion, LT recipients with cardiac events had limited survival as compared to the cohort without coronary events. Identification of such patients with noninvasive screening may provide a practical alternative to an invasive cardiac workup. Further improvement in screening strategies may minimize the liver transplant cardiac morbidity.
Related Concept Videos
01:28Kidney Transplant I: Introduction
01:26Kidney Transplant II: Surgical Procedure
01:16Kidney Transplant III: Nursing Management
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:26Coronary Artery Disease IV: Preventive Measures
01:30Coronary Artery Disease I: Introduction