Cardio-hepatic risk assessment by CMR imaging in liver transplant candidates

Clinical Transplantation
Sahadev T ReddyRobert W W Biederman

Abstract

The preoperative workup of orthotopic liver transplantation (OLT) patients is practically complex given the need for multiple imaging modalities. We recently demonstrated in our proof-of-concept study the value of a one-stop-shop approach using cardiovascular MRI (CMR) to address this complex problem. However, this approach requires further validation in a larger cohort, as detection of hepatocellular carcinoma (HCC) as well as cardiovascular risk assessment is critically important in these patients. We hypothesized that coronary risk assessment and HCC detectability is acceptable using the one-stop-shop CMR approach. In this observational study, patients underwent CMRI evaluation including cardiac function, stress CMR, thoracoabdominal MRA, and abdominal MRI on a standard MRI scanner in one examination. Over 8 years, 252 OLT candidates underwent evaluation in the cardiac MRI suit. The completion rates for each segment of the CMR examination were 99% for function, 95% completed stress CMR, 93% completed LGE for viability, 85% for liver MRI, and 87% for MRA. A negative CMR stress examination had 100% CAD event-free survival at 12 months. A total of 63 (29%) patients proceeded to OLT. Explant pathology confirmed detection/exclusi...Continue Reading

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Citations

Dec 11, 2019·Journal of Clinical Medicine·Yannis DimitroglouDimitris Tousoulis
Apr 27, 2020·Best Practice & Research. Clinical Anaesthesiology·Andrea De GasperiGianni Biancofiore
Apr 8, 2021·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Kameel Kassab, Rami Doukky
Nov 22, 2020·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Pranab M Barman, Lisa B VanWagner

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