Liver Transplantation Outcome in Patients with Angiographically-Proven Coronary Artery Disease: A Multi-Institutional Study
- Author(s): Steadman, Randolph Herbert
- Advisor(s): Elashoff, Robert M
- et al.
The impact of coronary artery disease (CAD) on survival after liver transplantation (LT) is poorly defined. This retrospective cohort study identified adult LT recipients who underwent pre-LT coronary angiography at seven institutions over a 12-year period. Obstructive CAD (≥50% stenosis) was present in 151 of 630 patients, the CAD(+) group. The remaining 479 patients comprised the CAD(-) group. Patient survival was similar for the CAD(+) group (adjusted HR 1.13, CI=[0.79, 1.62], p=0.49) compared to the CAD(-) group after a median follow-up of 24.5 months. 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=0.28) and CADmod (adjusted HR=0.93, CI=[0.52, 1.66], p=0.80) groups were similar to the CAD(-) group. With current CAD treatment strategies, post-LT survival is not significantly different between patients with and without angiographic evidence of obstructive CAD.