Utility of Coronary Artery Calcium Score for Coronary Artery Disease Screening among Severely Ill Liver Transplant Candidates: Case Series

Noninvasive cardiac stress testing is essential to screen liver transplant (LT) candidates for the presence of coronary artery disease (CAD). However, cardiac stress testing may not be clinically feasible in some patients, especially among those who require intensive care for an extended period of time, before being listed for LT. The utility of coronary artery calcium (CAC) score as a potential noninvasive screening test for CAD in place of cardiac stress testing among critically ill intensive care unit (ICU)-bound LT recipients has not been well studied. We report 4 LT recipients who were screened for CAD only with CAC score before listing for LT. Our results suggest that CAC score may be a useful test to screen for CAD in severely ill ICU-bound LT recipients with low risk for coronary heart disease, who are not candidates for cardiac stress testing. Such recipients requiring intensive care, with CAC score of 0A may safely forgo cardiac stress testing prior to LT. Future prospective studies with a bigger sample size and longer follow-up would be helpful to validate our findings.