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Screening Modalities for Coronary Artery Disease in Liver Transplant Candidates: A Review of the Literature

Cerise Kleb1, Omar T Sims2, Maan Fares3

  • 1Department of Gastroenterology, University of Maryland Medical Center, Baltimore, MD.

Journal of Cardiothoracic and Vascular Anesthesia
|September 10, 2023
PubMed

Insights

Identifying coronary artery disease (CAD) in liver transplant (LT) candidates is crucial for post-transplant survival. This review evaluates various screening methods for CAD in LT candidates, considering their unique physiological challenges.

Area of Science:

  • Cardiology
  • Hepatology
  • Transplant Surgery

Background:

  • Liver transplant (LT) candidates with cirrhosis face high risks of cardiopulmonary complications.
  • Coronary artery disease (CAD) significantly increases morbidity and mortality rates in post-LT patients.
  • Accurate CAD screening is vital for optimizing survival in LT candidates.

Purpose of the Study:

  • To review and describe various screening modalities for CAD in LT candidates.
  • To discuss the background, diagnostic accuracy, and limitations of each screening method.

Main Methods:

  • Literature review of current screening tests for CAD in LT candidates.
  • Analysis of diagnostic accuracy and limitations specific to patients with cirrhosis.
  • Evaluation of traditional vs. novel screening approaches.

Main Results:

  • Consensus on the optimal CAD screening test for LT candidates is lacking.
  • Traditional exercise and pharmacologic stress tests are often impractical and inaccurate in cirrhotic patients.
  • The review details the utility and drawbacks of different diagnostic modalities.

Conclusions:

  • Effective CAD screening is essential for improving outcomes in LT recipients.
  • Further research may be needed to establish definitive guidelines for CAD screening in this population.
  • Understanding the limitations of current tests is key to selecting appropriate screening strategies.

Keywords:
cardiac testingcardiovascular imagingcirrhosiscoronary artery diseaseliver transplant

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