Myocardial Perfusion Imaging in Liver Transplantation Candidates (ExSPECT)

University Hospital Birmingham NHS Foundation Trust

Status: Completed

Conditions: Liver Failure; Myocardial Perfusion Imaging

Treatments: Procedure: Myocardial perfusion imaging

Study type: Observational

Funder types: Other

Identifiers

NCT03864497

CARMS-14536

Details and patient eligibility

About

The optimal screening strategy for assessment of coronary artery disease in patients with end-stage liver disease (ESLD) is unclear. Although consensus based guidelines support noninvasive stress testing prior to orthotopic liver transplantation (OLT), no prospective studies are available to inform the clinician on perioperative risk stratification. This observational cohort study was designed to determine the prognostic utility of single photon emission computed tomography (SPECT) imaging in OLT candidates.

Full description

Controversy over whether SPECT imaging offers clinical utility in ESLD has been fuelled by conflicting reports on its accuracy to diagnose CAD in this setting. Moreover, there are no studies examining whether SPECT imaging provides any incremental prognostic value beyond functional testing in this high-risk cohort. We sought to determine the relative importance of CV risk factors, functional capacity and SPECT perfusion results as independent predictors of cardiovascular mortality in OLT candidates.

Enrollment: 403 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Liver transplantation candidates with one or more of the following:

• inability to perform >4 METs by history
• insulin-treated diabetes mellitus
• serum creatinine >152μmol/l
• history of MI, PCI or CABG
• stable angina
• cerebrovascular disease
• peripheral vascular disease

Exclusion criteria

• Age < 18 years
• Pregnancy
• Contraindication to liver transplantation

Trial design

403 participants in 1 patient group

Orthotopic liver transplantation candidates

Description:

No intervention, imaging test and risk stratification as part of routine clinical care.

Treatment:

Procedure: Myocardial perfusion imaging