Impacto da doença arterial coronária na mortalidade tardia de hepa- topatas crônicos em programa de transplante hepático Impact of the coronary artery disease on the late mortality of chronic liver patients in the liver transplant program

Introduction: Coronary artery disease has a significant prevalence in patients with advanced liver failure causing complications related to cardiovascular events and/or myocardial ischemia, increasing morbidity and mortality. The presence of coronary artery disease may also contraindicate liver transplantation. Objective: To compare the long-term mortality of patients with advanced liver failure with coronary artery disease compared to those without coronary artery disease. Patients and Methods: Analysis of 154 patients over 40 years age, who was waiting in line for liver transplantation in a reference service and who underwent cardiac catheterization as part of pre-operatory evaluation. Results Of the 154 patient who underwent catheterization, 40 patients (26.0%) had some degree of coronary vessel obstruction. Of the total cases, 75 cases were submitted to liver transplantation and 13 cases (17.3%) had obstructive coronary artery disease. There was a prevalence of coronary artery disease in the non-transplanted group (p = 0.0183, Fisher’s exact test, two-tailed). A comparative analysis with the aid of Kaplan-Meier curves for survival free of death showed that the best survival rate (53.8 ± 13.8% at the end of 3418 days with a mean survival of 1881.7 days (95% CI – 891.6 to 2871.7 days)) occurred in the group of liver transplantation in patients with Coronary disease. The worst survival rate (11.7 ± 10.5% at the end of 2295 days with a median survival of 565 days (95% CI – 321 to 995 days) and mean survival of 852.8 days (95% CI - 432.9 to 1272.8 days), occurred in the group of patients non-transplanted and with coronary disease. Conclusion: We found that the presence of obstructive coronary artery disease of any degree is no contraindication to performing liver transplantation in patients with advanced chronic liver disease since the best survival rate occurred justly in the group of transplanted patients with obstructive coronary disease.