No funding

The overall goal of this study is to determine if non-invasive imaging with state of the art CT coronary angiography can be used to screen for coronary artery disease in high risk patients prior to liver and lung transplantation. The current protocol for coronary artery disease assessment at UCSF before liver and lung transplantation involves screening with stress tests and/or coronary angiograms in patients with increased risk of coronary artery disease. Coronary angiogram will be used as gold standard for assessment of coronary CTA accuracy.

Inclusion Criteria:

1. Liver transplant candidates referred for invasive coronary angiography which include:

   • Patients with suspicious symptoms for CAD or;
   • Asymptomatic patients;
   • Abnormal non-invasive testing or 1 major risk factor for coronary artery disease or LVEF < 60% on echo.

2. Lung transplant candidates referred for invasive coronary angiography which include:

   • Patients with suspicious symptoms for CAD or;
   • Asymptomatic patients;
   • Abnormal non-invasive testing or 1 major risk factor for coronary artery disease or LVEF < 60% on echo in patients with low SVR (typical for ESLD).

3. Any ethnic background is acceptable.

Exclusion Criteria:

1. Patients with contraindications for the use of iodinated contrast (allergic reaction, renal failure, multiple myeloma, etc) will be excluded.
2. Children and pregnant women will be excluded because of risks associated with radiation exposure.
3. Patients must have no atrial fibrillation, as this will interfere with cardiac gating for the examination.
4. Patients unable to give informed consent will be excluded as well.

Liver and lung transplant candidates referred for coronary angiography.