The Minimisation of Cardiovascular Disease Screening for Kidney Transplant Candidates

Area of Science:

• Nephrology
• Cardiology
• Transplantation Medicine

Background:

• Growing evidence suggests pre-kidney transplant cardiac screening offers no outcome benefits.
• Risk aversion leads to common testing, limiting real-world data for practice change.
• Minimal screening data is needed to evaluate perioperative and post-transplant cardiovascular events.

Purpose of the Study:

• To assess perioperative and 1-year post-transplant cardiovascular events.
• To evaluate outcomes in kidney transplant candidates receiving minimal cardiovascular screening.

Main Methods:

• Retrospective cohort study of adult kidney-only transplant recipients (Jan 2015 - Dec 2021).
• Asymptomatic recipients, even with risk factors, did not undergo cardiac stress testing.
• Logistic regression identified predictors of cardiovascular or cerebrovascular events.

Main Results:

• 895 recipients included; 23% had prior cardiac diagnosis, 22% had diabetes.
• Perioperative events occurred in 2% (18 patients); 5.7% had 1-year post-transplant cardiovascular events.
• Cardiovascular mortality was 0% perioperatively, 0.2% at 3 months, and 0.2% at 1 year.

Conclusions:

• Reduced screening in asymptomatic kidney transplant recipients showed comparable cardiovascular event rates.
• Study included higher-risk individuals, suggesting extensive screening may not be beneficial.
• Findings support that extensive pre-transplant cardiac screening is unlikely to be offset by reduced cardiovascular events.