Document Detail

Multivessel coronary artery disease predicts mortality, length of stay, and pressor requirements after liver transplantation.
MedLine Citation:
PMID:  21031539     Owner:  NLM     Status:  In-Process    
The optimal preoperative cardiac evaluation strategy for patients with end-stage liver disease (ESLD) undergoing liver transplantation remains unknown. Patients are frequently referred for cardiac catheterization, but the effects of coronary artery disease (CAD) on posttransplant mortality are also unknown. We sought to determine the contribution of CAD and multivessel CAD in particular to posttransplant mortality. We performed a retrospective study of ESLD patients undergoing cardiac catheterization before liver transplant surgery between August 1, 2004 and August 1, 2007 to determine the effects of CAD on outcomes after transplantation. Among 83 patients who underwent left heart catheterization, 47 underwent liver transplantation during the follow-up period. Twenty-one of all ESLD patients who underwent liver transplantation (45%) had CAD. Fifteen of the transplant patients with CAD (71%) had multivessel disease. Among transplant patients, the presence of multivessel CAD (versus no CAD) was predictive of mortality (27% versus 4%, P = 0.046), increased length of stay (22 versus 15 days, P = 0.050), and postoperative pressor requirements (27% versus 4%, P = 0.029). Interestingly, neither the presence of any CAD nor the severity of stenosis in any single coronary artery predicted mortality. Furthermore, none of the traditional clinical predictors (age, gender, diabetes, creatinine, ejection fraction, and Model for End-Stage Liver Disease score) were predictive of mortality among transplant recipients. In conclusion, multivessel CAD is associated with higher mortality after liver transplantation when it is documented angiographically before transplantation, even in the absence of severe coronary artery stenosis. This study provides preliminary evidence showing that there may be significant prognostic value in coronary angiography as a part of the pretransplant workup.
Celina M Yong; Madan Sharma; Victor Ochoa; Freddy Abnousi; John Roberts; Nathan M Bass; Claus U Niemann; Stephen Shiboski; Megha Prasad; Mehdi Tavakol; Thomas A Ports; Gabriel Gregoratos; Yerem Yeghiazarians; Andrew J Boyle
Related Documents :
9663719 - Review article: the management of acute liver failure.
11499909 - Relevance of two-stage total hepatectomy and liver transplantation in acute liver failu...
1802729 - Effect of rearterialization on short-term graft function in orthotopic rat liver transp...
15838869 - Nonischemic cardiomyopathy after orthotopic liver transplantation: a report of three ca...
11544539 - Liver failure with marked hyperferritinemia: 'ironing out' the diagnosis.
19602759 - Aspergillus endophthalmitis in orthotopic liver transplantation.
24126439 - Renal histopathology during experimental septic acute kidney injury and recovery.
12042949 - How i do it: pre-operative ct scanning for adult living right lobe liver transplantation.
24796329 - Diagnosis and surgical treatment of renal hydatid disease: a retrospective analysis of ...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society     Volume:  16     ISSN:  1527-6473     ISO Abbreviation:  Liver Transpl.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100909185     Medline TA:  Liver Transpl     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1242-8     Citation Subset:  IM    
Copyright Information:
© 2010 AASLD.
Division of Cardiology, Department of Medicine, University of California San Francisco, San Francisco, CA 94143, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Differences in portal hemodynamics between whole liver transplantation and living donor liver transp...
Next Document:  Pretransplant risk factors for new-onset diabetes mellitus after transplant in pediatric liver trans...