Journal List > J Korean Soc Transplant > v.25(4) > 1034347

J Korean Soc Transplant. 2011 Dec;25(4):225-228. Korean.
Published online December 31, 2011.  https://doi.org/10.4285/jkstn.2011.25.4.225
Copyright © 2011 The Korean Society for Transplantation
Cardiovascular Screening before Transplantation
Yong-Lim Kim, M.D.
Clinical Research Center for ESRD and Division of Nephrology, Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea.

Corresponding author (Email: ylkim@knu.ac.kr )
Received November 19, 2011; Accepted November 21, 2011.

Abstract

Because of the high prevalence of clinically silent cardiovascular disease and increased incidence of adverse cardiovascular events in transplant recipients, cardiovascular evaluation before transplantation is critical. The standard non-invasive screening tests for evaluating coronary artery disease include dobutamine stress echocardiogram and myocardial perfusion image (adenosine, dipyridamole nuclear scintigraphy). The optimal non-invasive screening test is unclear, with the optimal choice based upon the expertise of the particular medical center. The practitioner is advised to view current guidelines as recommendations rather than as strict rules and to combine them with clinical judgments. In addition, excessive reliance on noninvasive tests that are not sufficiently accurate to exclude significant coronary artery disease in high-risk candidates may engender a false sense of security.

Keywords: Transplantation; Mass screening; Cardiovascular diseases

Figures


Fig. 1
Algorithm for cardiac assessment of high risk patients on the waiting list for kidney transplantation.
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Fig. 2
Plain lumbar spine X-ray showing vascular calcification (white arrow).
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Tables


Table 1
High risk patients needed for more intense monitoring for coronary artery disease
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Table 2
Cardiac testing modalities for the presence of coronary artery disease: sensitivity, specificity, predictive value
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Table 3
Recommendations for cardiac surveillance of kidney transplantation waitlisted patients
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