Perioperative cardiac risk assessment in kidney transplantation: It’s time to search for a new gold standard

Excerpt

Increased cardiac risk associated with advanced chronic kidney disease (CKD) poses a particular challenge when evaluating candidates for renal transplantation. The incidence of myocardial infarction (MI) in renal transplant candidates is considerable, ranging 8.7%-16.7% by 3 years after transplant listing and 4.7%-11.1% after transplantation.1 Alarmingly, almost half of the deaths that occur within 30 days after kidney transplantation are due to MI.2 With little data to help guide cardiac risk stratification and even fewer tools to mitigate that risk, not only do transplant teams have to contend with a challenging peri-transplant period, they must also grapple with how to ethically, yet prudently allocate scarce donor organs in an extraordinarily high-risk patient population. …