None listed
Conditions
Brief summary
Liver disease affects over 5 million Australians. In patients with advanced liver disease, liver transplantation is a valuable yet scarce resource with the ability to transform the lives of patients. Our research at Austin Health has shown that cardiovascular disease is a leading cause of early and late adverse outcomes after liver transplantation. The development of cardiovascular disease may limit the benefit of liver transplantation. A proposed mechanism for this observation is accelerated development of plaque build-up in coronary arteries, also known as atherosclerosis. Atherosclerosis is a condition that can increase the risk of heart attack in patients after liver transplantation. Computed Tomography (CT) imaging of coronary arteries can be performed in patients to assess their cardiac risk before liver transplantation. Plaque build-up in coronary arteries identified on CT imaging has been shown to adversely impact outcomes at the time of transplantation. However, no studies have evaluated the progression of plaque build-up in patients after transplantation. If liver transplantation causes accelerated atherosclerosis in coronary arteries, the current algorithms for surveillance and therapy of cardiovascular risk may need to be redefined. We propose to undertake repeat CT imaging of the coronary arteries at least two years after liver transplantation, in patients who had CT imaging before transplantation. The aim is to assess whether transplantation is a risk factor for progression of plaque build-up, which can predispose to future heart attack. The CT imaging of liver transplant patients will be compared to a control group of liver disease patients who did not undergo transplantation.
Interventions
Study design
Study the effect of liver transplantation on the progression of atherosclerosis.
Inclusion criteria:
As per current Victorian Liver Transplant Unit guidelines, all intermediate-high risk patients undergo outpatient Computed tomography coronary angiography (CTCA) as a pre-transplant work-up. In this study, patients that have undergone CTCA before LT are invited to undergo a repeat CTCA a minimum of two years after LT with serial biomarkers. Each CT scan will take approximately 30
Study design Study the effect of liver transplantation on the progression of atherosclerosis. Inclusion criteria: As per current Victorian Liver Transplant Unit guidelines, all intermediate-high risk patients undergo outpatient Computed tomography coronary angiography (CTCA) as a pre-transplant work-up. In this study, patients that have undergone CTCA before LT are invited to undergo a repeat CTCA a minimum of two years after LT with serial biomarkers. Each CT scan will take approximately 30 minutes. As this study aims to recruit only patients with a prior clinically indicated CT scan, we would only aim to observe each participant for the duration of the CT study. Blood tests will only be performed once at the same encounter.
Sponsors
A/Prof Omar Farouque
Eligibility
Sex/Gender
All
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
1. Patients who have undergone a CT coronary angiogram prior to liver transplantation. 2. A time period of at least 2 years following liver transplantation 3. Subjects who had a CT coronary angiogram without significant artefacts
Exclusion criteria
- severe renal dysfunction eGFR <30 - contrast allergy - prior CT demonstrating extensive coronary disease or coronary stents
Outcome results
None listed