How Important is Coronary Artery Disease when Considering Lung Transplant Candidates?

Background Coronary artery disease (CAD) remains a relative contraindication for lung transplantation, but should it be if amenable to effective palliation? Methods From January 2005 to July 2010, 356 adults undergoing primary lung transplantation had no significant ( .8), and early longitudinal post-transplant pulmonary function ( P= .2) were similar, as was time-related mortality: 20% vs. 22% and 51% vs. 52% at 1 and 4 years, respectively ( P =.6). Unmatched no-CAD patients had fewer comorbidities and lower mortality than matched patients (15% and 39% at 1 and 4 years, respectively; P= .01). Conclusions CAD is an important risk factor in lung transplant candidates, but its influence can be minimized in experienced centers by effective palliation. Surprisingly, however, CAD is a marker for an unfavorable patient phenotype with worse than typical post-transplant survival, irrespective of whether CAD is present.