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Cardiac Assessment for Renal Transplantation
Author(s) -
Pilmore H.
Publication year - 2006
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/j.1600-6143.2006.01253.x
Subject(s) - medicine , transplantation , cardiology , coronary artery disease , asymptomatic , population , kidney transplantation , revascularization , aspirin , myocardial infarction , environmental health
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.