Is the presence of surgically treatable coronary artery disease a contraindication to liver transplantation?

Advanced coronary artery disease has been traditionally considered an absol ute contraindication to orthotopic liver transplantation where chronic live r failure significantly increases the surgical risk for coronary artery byp ass grafting. Performing a simultaneous coronary artery bypass grafting and liver transplant is a theoretically attractive strategy in liver transplan t candidates with coronary artery disease in need of revascularization. In the present article, we report a successful simultaneous coronary artery by pass grafting and orthotopic liver transplant with 1-yr post-operative foll ow-up and we discuss the rationale for this approach. In selected cases, th e presence of advanced coronary artery disease should not be considered an absolute contraindication to liver transplantation.