Cardiovascular Risk Assessment in Renal and Liver Transplant Candidates: A Multidisciplinary Institutional...

Area of Science:

• Cardiology
• Nephrology
• Hepatology
• Transplant Surgery

Background:

• Transplant candidates exhibit rising medical complexity, notably cardiovascular disease (CVD).
• CVD is the leading cause of death post-kidney transplant globally.
• Increasing end-stage liver disease from nonalcoholic steatohepatitis and higher MELD scores correlate with heightened CVD risk in liver transplant candidates.

Purpose of the Study:

• To review and establish clinical practice guidelines for cardiac testing in renal and liver transplant candidates.
• To standardize patient selection for cardiac evaluation.
• To reduce adverse cardiac events in the post-transplant period.

Main Methods:

• Multidisciplinary guideline development involving transplant nephrology, hepatology, surgery, and cardiology (general and interventional).
• Review of existing clinical practice guidelines and transplant center patterns.
• Focus on improving patient selection criteria for cardiac testing.

Main Results:

• Identified significant variation in current guidelines and practice patterns for cardiac testing in transplant candidates.
• Established a multidisciplinary approach to standardize cardiac evaluation protocols.
• Aimed to optimize the selection of patients requiring cardiac assessment.

Conclusions:

• Standardized, multidisciplinary guidelines are crucial for managing complex cardiovascular risk in transplant candidates.
• Improved patient selection for cardiac testing can mitigate post-transplant mortality.
• Adherence to established protocols can enhance outcomes for renal and liver transplant recipients.