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Coronary Artery Disease and Coronary Artery Bypass Grafting at the Time of Lung Transplantation Do Not Impact Overall Survival

Halloran, Kieran1,2; Hirji, Alim1,2; Li, David1; Jackson, Kathy1; Kapasi, Ali1,2; Meyer, Steve1,3; Mullen, John1,3; Lien, Dale1,2; Weinkauf, Justin1,2

doi: 10.1097/TP.0000000000002609
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Background: Coronary artery disease (CAD) is common in lung transplant candidates and may require revascularization before or at the time of their transplant. We reviewed the survival of lung transplant recipients with coronary artery disease requiring surgical intervention (CAD-CABG) and those who did not (CAD-NoCABG) at the time of transplant, compared to a cohort with no CAD (NoCAD).

Methods: We conducted a retrospective cohort study of adult patients transplanted in our program between 2004-2013. Our primary outcome was the association between 3-way CAD status (CAD-CABG, CAD-NoCABG, NoCAD) and overall retransplant-free survival via proportional hazards modelling, adjusting for age, gender and transplant indication. Secondary endpoints included 1-year survival, survival by Kaplan-Meier analysis, duration of ventilation, ICU stay and hospitalization.

Results: 333 patients underwent transplant during the study timeframe. 24 (7%) had CAD requiring CABG, 82 (25%) had CAD not requiring CABG and the remaining 227 had no CAD. 3-way CAD status was not associated with overall retransplant-free survival after adjustment for age, gender and transplant indication. Duration of mechanical ventilation, ICU stay and hospitalization were longer in both CAD groups compared to the NoCAD group.

Conclusions: CAD status does not impact overall retransplant-free survival, despite greater perioperative complexity. Prospective studies comparing treatment strategies in these patient groups are warranted.

1Lung Transplant program, Alberta Health Services, Edmonton, Canada

2Department of Medicine, University of Alberta, Edmonton, Canada

3Department of Surgery, University of Alberta, Edmonton, Canada

DISCLOSURE: The authors of this manuscript have no disclosures of note. This study was unfunded. We acknowledge the University of Alberta Hospital and Alberta Health Services for use of resources.

Corresponding Author: Kieran Halloran, MD, University of Alberta, 11350 83rd Street, 3-125 Clinical Sciences Building, Edmonton, Alberta, Canada T6G2G3, Telephone: 1-780-492-2691 Fax: 1-780-492-4483, Email: kieran.halloran@ualberta.ca

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