Coronary multidetector computed tomographic angiography to evaluate coronary artery disease in liver transplant candidates: Methods, feasibility and initial experience

Aoife N. Keeling, James D Flaherty, Amir H. Davarpanah, Andrew Ambrosy, Cormac T. Farrelly, Matthew E. Harinstein, Steven L Flamm, Michael Messod Abecassis, Anton I Skaro, James Carr, Mihai Gheorghiade*

*Corresponding author for this work

Research output: Contribution to journalArticle

25 Scopus citations


Aims: In patients undergoing orthotopic liver transplantation (OLT), coronary artery disease (CAD), obstructive and nonobstructive, is associated with high morbidity and mortality. In OLT candidates, stress testing for detecting ischemia is often inaccurate, and this patient population often has relative contraindications for cardiac catheterization. The objective of this study was to describe the methods, assess the feasibility and determine the extent and severity of CAD in OLT candidates without a prior history of CAD using coronary multidetector computer tomographic angiography (MDCTA). Methods: Sixty-five OLT candidates without known CAD underwent coronary MDCTA with dual source cardiac computed tomography (Siemens Definition). Coronary arteries were divided into 17 segments based on American Heart Association guidelines and evaluated independently by two blinded reviewers. Image quality of coronary MDCTA was assessed on a four-point Likert scale (0 = poor, 1 = fair, 2 = good, and 3 = excellent). Atherosclerotic lesions were evaluated for severity [mild (0-50%), moderate (51-70%), and severe (71-100%)], morphology, extent, location and consistency. Results: Image quality was graded as good or excellent in 73.8%. In this cohort of OLT candidates without known CAD, 9% had normal coronary arteries, 58% had mild CAD and 34% had moderate to severe CAD. Plaque severity and burden scores were high. Conclusion: The prevalence of asymptomatic CAD is high in OLT candidates. Coronary MDCTA is feasible in OLT candidates and appears to be a useful technique to diagnose occult CAD in this patient population.

Original languageEnglish (US)
Pages (from-to)460-468
Number of pages9
JournalJournal of Cardiovascular Medicine
Issue number7
StatePublished - Jul 1 2011



  • computed tomography
  • coronary artery disease
  • end-stage liver disease
  • orthotopic liver transplant
  • plaque

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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