Screening Stress Myocardial Perfusion Imaging and Eligibility for Liver Transplantation

Statin intolerance – an attempt at a unified definition. Position paper from an International Lipid Expert Panel

“…Thus, the fear of a possible drug adverse effect, which is extremely rare, might be a reason that many patients needlessly suffer or die from cirrhosis, HCC or CVD events [126]. Moreover, 7% to 29% of liver transplantation candidates are denied listing as potential recipients because of CVD [127]; they may have been eligible for listing if they had been on statin therapy [127].…”

Cardiac Disease Evaluation and Management Among Kidney and Liver Transplantation Candidates

“…282,285,286 In a series of 772 consecutive liver transplantation candidates who underwent MPS at 1 center, 710 were thought to be at low risk, 36 at intermediate risk, 17 at high risk, and 9 had incomplete studies. 287 All patients considered to be at high risk on the basis of stress imaging underwent coronary angiography. A total of 26 patients with positive MPS and angiographic evidence of CAD were denied transplantation; however, CAD was the sole reason for denial in only 7 patients.…”

Safety of regadenoson in patients with end-stage liver disease

“…12,13 Most patients undergoing stress MPI for liver transplant evaluation have normal myocardial perfusion, which led some to question the benefit of such studies. 5,14 Also, the many competing factors that affect eligibility for transplantation may further limit the value of the screening MPI. 14 Yet, the prevalence of CAD in patients with ESLD varies from 3% to 16%, 15,16 and has been shown to be associated with increased peri-operative mortality.…”