*Purpose: There is an increase in percentage of patients over the age of 65 yrs. who are being listed for liver transplantation (LT). Patients with older age frequently have Diabetes mellitus (DM), Coronary artery disease (CAD) and Hypertension (HTN). These conditions along with age > 60 yrs. are independent risk factors for developing Afib. We aimed to evaluate the outcomes of LT in patients with underlying Afib who underwent LT at our center.

*Methods: We reviewed the electronic medical records of all the patients who underwent LT at our center from 2009-16. All the patients who had Afib Pre and post-LT were included in the study. Kaplan- Meier estimator was applied to analyze patient survival in the both groups. The p values were calculated using Mann-Whitney or Chi-square statistical tests.

*Results: Total number of patients who underwent LT at our center during this period was 513. Of these, 67 patients had Chronic Afib (pre-LT and post-LT) and 446 did not. The median age at time of LT was 62± 10 yrs. in patients with Afib and 57±12 yrs. (p<0.001) in patients who did not have Afib. Clinically significant proportion of patients with Afib had Diabetes (79.1% vs 61.2%; p:0.005), coronary artery disease (CAD) (31.1% vs 11.2%; p-0.001) and history of Coronary artery bypass grafting. MELD score at listing and at transplant was similar in both groups. The overall patient survival was lower in patients with Afib as compared to those who did not have Afib. (p-0.001)

*Conclusions: Patients with Atrial Fibrillation had decreased survival post- liver transplantation. These patients frequently had DM, CAD and CABG. As the age of patients on transplant waitlist increases, we will see more patients with Afib on LT waitlist. These patients need to be co-managed with cardiology. Prospective studies are needed to evaluate long term outcomes in this group of patients.

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