Impact of Abdominal Aortic Calcification Among Liver Transplantation Recipients

Liver Transpl. 2019 Jan;25(1):79-87. doi: 10.1002/lt.25311.

Abstract

Abdominal aortic calcification (AAC) is known as a risk factor of coronary artery disease, stroke, hyperphosphatemia, chronic inflammation, diabetes, and decreased estimated glomerular filtration rate. However, the clinical implications of incidental AAC findings in liver transplantation (LT) have not been evaluated in terms of posttransplantation survival and complications. Therefore, we analyzed the relationships between the AAC level and the outcomes following LT. A total of 156 consecutive patients who underwent LT between January 2007 and December 2014 were divided into 2 groups according to their AAC level (<100 mm3 or ≥100 mm3 ), as calculated using the Agatston method. Even after propensity matching, the survival time was significantly longer in the low-AAC group compared with that in the high-AAC group (median survival time, 4.5 versus 3.0 years; P < 0.01). A multivariate analysis identified high AAC level (hazard ratio, 2.2) and old donor age (hazard ratio, 2.2) as prognostic factors for overall survival. In conclusion, high AAC is an independent unfavorable prognostic factor in LT.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aorta, Abdominal / diagnostic imaging
  • Aorta, Abdominal / pathology*
  • Computed Tomography Angiography
  • End Stage Liver Disease / complications
  • End Stage Liver Disease / mortality
  • End Stage Liver Disease / surgery*
  • Female
  • Humans
  • Liver Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Preoperative Period
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Survival Analysis
  • Tissue Donors / statistics & numerical data
  • Transplant Recipients / statistics & numerical data
  • Vascular Calcification / complications
  • Vascular Calcification / diagnosis
  • Vascular Calcification / epidemiology*