Journal article
Outcomes of Liver Transplantation in Patients With Preexisting Coronary Artery Disease
Transplantation, Vol.107(4), pp.933-940
04/01/2023
DOI: 10.1097/TP.0000000000004402
PMID: 36397734
Abstract
Background. Advances in surgical and medical technology over the years has made liver transplantation possible for older and higher risk patients. Despite rigorous preoperative cardiac testing, cardiovascular events remain a major cause of death after orthotopic liver transplantation (OLT). However, there are little data on the outcomes of OLT in patients with preexisting coronary artery disease (CAD). This study aimed to compare all-cause and cardiovascular mortality of patients with and without history of CAD undergoing OLT. Methods. Six hundred ninety-three adult patients with cirrhosis underwent liver transplantation between July 2013 and December 2018 (female n = 243, male n = 450; median age 59). Results. During the study period of 5 y (median follow-up, 24.1 mo), 92 of 693 patients (13.3%) died. All-cause mortality in the CAD group was significantly higher than in the non-CAD group (26.7% versus 9.6%; P<0.01). Cardiovascular events accounted for 52.5% of deaths (n = 21) in patients with CAD compared with 36.5% (n = 19) in non-CAD patients. At 6 mo, patients with combined nonalcoholic steatohepatitis (NASH)/CAD had significantly worse survival than those with CAD or NASH alone (P<0.01). After 6 mo, patients with CAD alone had similar survival to those with combined NASH/CAD. Conclusions. Patients with preexisting CAD before liver transplantation are at higher risk of death from any cause, specifically cardiovascular-related death. This risk increases with coexisting NASH. The presence of NASH and CAD at the time of liver transplant should prompt the initiation of aggressive risk factor modification for patients with CAD.
Details
- Title: Subtitle
- Outcomes of Liver Transplantation in Patients With Preexisting Coronary Artery Disease
- Creators
- Emily Reznicek - Cleveland Clin Fdn, Dept Internal Med, Cleveland, OH USAKazunari Sasaki - Cleveland Clin, Cleveland, OH USABryce Montane - Cleveland Clin Fdn, Dept Internal Med, Cleveland, OH USAAriel Sims - Cleveland Clin Fdn, Dept Internal Med, Cleveland, OH USAJonathan Beard - Cleveland Clin Fdn, Dept Internal Med, Cleveland, OH USAMaan Fares - Cleveland Clin, Dept Cardiol, Cleveland, OH USAVikram Sharma - Cleveland Clin, Cleveland, OH USAJacek Cywinski - Cleveland Clin, Dept Anesthesiol, Cleveland, OH USAChristiano Quintini - Cleveland Clin Ohio, Cleveland, OH USAFederico N. Aucejo - Cleveland Clin Fdn, Digest Dis & Surg Inst, Cleveland, OH USABijan Eghtesad - Cleveland Clin Fdn, Digest Dis & Surg Inst, Cleveland, OH USACharles M. Miller - Cleveland Clin Ohio, Cleveland, OH USAK. V. Narayanan Menon - Cleveland Clin Fdn, Digest Dis & Surg Inst, Cleveland, OH USA
- Resource Type
- Journal article
- Publication Details
- Transplantation, Vol.107(4), pp.933-940
- Publisher
- Lippincott Williams & Wilkins
- DOI
- 10.1097/TP.0000000000004402
- PMID
- 36397734
- ISSN
- 0041-1337
- eISSN
- 1534-6080
- Number of pages
- 8
- Language
- English
- Date published
- 04/01/2023
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984806608302771
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