Kidney Transplant Research Today is a free monthly online journal that collates and summarizes the latest research about Kidney Transplant, including details on risks, prognosis, procedure, surgery, organ donation.

Cardiac assessment for renal transplantation.

Pilmore H

Renal Medicine, Auckland City Hospital, Park Road, Grafton, Auckland 00001, New Zealand. hpilmore@adhb.govt.nz

Cardiac death is common in patients with end-stage renal failure. Screening for coronary artery disease prior to renal transplantation is advisable in high-risk patients. The optimal screening test has not been defined; however, myocardial perfusion studies are more sensitive than exercise electrocardiography and are less invasive than coronary angiography, which remains the gold standard. The management of coronary artery disease prior to transplantation is contentious. Revascularization of coronary artery stenoses is associated with high mortality and morbidity in the renal failure population, and there is little data to indicate that most patients with asymptomatic coronary lesions will benefit from prophylactic coronary intervention. In addition, beta-blockers and aspirin are under-utilized in the renal population. This paper reviews the literature and proposes algorithms for the cardiac assessment and management of patients prior to renal transplantation.

Published 16 March 2006 in Am J Transplant, 6(4): 659-65.
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