Related Experiment Video
Updated: Feb 2, 2026
A Modified Surgical Technique for Kidney Transplantation in Mice
Published on: July 22, 2022
Comparison of interventional and surgical myocardial revascularization in kidney transplant recipients - A
Jeannine Lang1,2, Stefan Buettner1,2, Helge Weiler1,2
1Department of Internal Medicine III, Division of Cardiology and Nephrology, University Hospital Frankfurt, Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany.
Insights
For kidney transplant recipients with coronary artery disease, percutaneous coronary intervention (PCI) may offer better outcomes than coronary artery bypass grafting (CABG), including lower mortality and acute kidney injury. Further research is needed to confirm these findings.
Area of Science:
- Cardiology
- Nephrology
- Transplantation Medicine
Background:
- Kidney transplant recipients (KTR) are at high risk for coronary artery disease (CAD), a leading cause of death in this population.
- Limited data exist on optimal revascularization strategies for KTR due to their exclusion from major studies and guidelines.
Purpose of the Study:
- To compare the effectiveness and safety of percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG) for myocardial revascularization in KTR.
- To evaluate in-hospital mortality, survival rates, and graft survival between PCI and CABG in this high-risk cohort.
Main Methods:
- Retrospective single-center study of KTR undergoing myocardial revascularization for multivessel or left main CAD between 2005 and 2015.
- Comparison of outcomes between patients treated with PCI (n=27) and CABG (n=24).
- Assessment of in-hospital mortality, one-year and four-year survival, acute kidney injury (AKI), and graft survival.
Main Results:
- In-hospital mortality was 14.8% for PCI versus 20.8% for CABG (p=0.45).
- One-year survival was higher in the PCI group (85.2%) compared to CABG (75%).
- Acute kidney injury (AKI) was significantly more frequent after CABG (58.3%) than PCI (18.5%) (p<0.01).
- Four-year graft survival was comparable between PCI (76.8%) and CABG (77.0%) (p=0.78).
Conclusions:
- Percutaneous coronary intervention (PCI) appears superior to coronary artery bypass grafting (CABG) in kidney transplant recipients regarding in-hospital mortality, acute kidney injury, and one-year survival.
- Outcomes regarding long-term graft survival were similar between PCI and CABG.
- Larger studies are necessary to optimize treatment strategies for high-risk KTR with CAD.
Background:
Kidney transplant recipients (KTR) reflect a high-risk population for coronary artery disease (CAD). CAD is the most common cause for morbidity and mortality in this population. However, only few data are available on the favourable revascularization strategy for these patients as they were often excluded from studies and not mentioned in guidelines.
Methods:
This retrospective single-centre study includes patients with a history of kidney transplantation undergoing myocardial revascularization for multivessel or left main CAD by either percutaneous coronary intervention (PCI, n = 27 patients) or coronary artery bypass grafting (CABG, n = 24 patients) at University Hospital Frankfurt, Germany, between 2005 and 2015.
Results:
In-hospital mortality was higher in the CABG group (20.8% vs. 14.8% PCI group; p = 0.45). In Kaplan-Meier analysis, one-year-survival showed better outcome in the PCI group (85.2% vs. 75%). After four years, outcome was comparable between both strategies (PCI 66.5% vs. CABG 70.8%; log-rank p = 0.94).Acute kidney injury (AKI), classified by Acute Kidney Injury Network, was observed more frequently after CABG (58.3% vs. 18.5%; p < 0.01). After one year, graft survival was 95.7% in the PCI group and 94.1% in the CABG group. Four year follow-up showed comparable graft survival in both groups (76.8% PCI and 77.0% CABG; p = 0.78).
Conclusion:
In this retrospective single-centre study of KTR requiring myocardial revascularization, PCI seems to be superior to CABG with regard to in-hospital mortality, acute kidney injury and one-year-survival. To optimise treatment of these high-risk patients, larger-scaled studies are urgently warranted.
Related Concept Videos
01:26Kidney Transplant II: Surgical Procedure
01:28Kidney Transplant I: Introduction
01:16Kidney Transplant III: Nursing Management
01:45Kidney Structure
01:03Nursing Interventions I: Taxonomy of Nursing Interventions
A nursing intervention is a treatment or action based on scientific concepts and knowledge from the nursing, behavioral, and physical sciences. Identifying and prioritizing nursing interventions based on the desired outcome...
01:29Nursing Interventions II: Selecting and Classifying the Nursing Interventions