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Updated: Apr 16, 2026
Murine Kidney Transplant Technique
Published on: October 20, 2015
Coronary Artery Bypass Graft as a Bridge to Kidney Transplantation
Zachary W Sollie1, Chakradhari Inampudi2, Jingwen Zhang3
1Division of Cardiothoracic Surgery, Department of Surgery, Medical University of South Carolina, Charleston, South Carolina.
Insights
Coronary artery bypass grafting (CABG) can enable kidney transplant (KT) eligibility for some patients with severe coronary artery disease. While mortality exists, a portion of these patients successfully receive a transplant after CABG.
Area of Science:
- Cardiology
- Nephrology
- Transplant Surgery
Background:
- Severe coronary artery disease (CAD) frequently prevents patients from qualifying for kidney transplantation (KT).
- Coronary artery bypass grafting (CABG) is not well-established as a strategy to facilitate KT eligibility.
- This study evaluates outcomes of CABG used as a bridge to KT.
Purpose of the Study:
- To describe postoperative outcomes following CABG in patients evaluated for KT.
- To assess KT waitlist outcomes for patients who underwent CABG.
- To determine the efficacy of CABG as a bridge to kidney transplantation.
Main Methods:
- Retrospective review of 60 patients undergoing CABG for KT eligibility (August 2020 - May 2025).
- Primary outcomes included all-cause mortality, major adverse cardiovascular events (MACE), and subsequent KT incidence.
- Median follow-up was 549 days.
Main Results:
- 18.3% of patients died within 1 year post-CABG.
- 1-year MACE included stroke (3.3%), myocardial infarction (11.9%), and percutaneous coronary intervention (6.7%).
- 18.3% of patients received a KT, with a median time of 564 days from CABG to KT.
Conclusions:
- CABG as a bridge to KT is associated with significant short-term and 1-year mortality.
- A subset of patients can achieve KT eligibility after undergoing CABG.
- Further research is needed to optimize preoperative decision-making for this patient group.
Introduction:
Severe coronary artery disease is often a barrier to kidney transplant (KT) evaluation. Coronary artery bypass graf (CABG) as a bridge to KT eligibility is not well studied. This analysis describes CABG postoperative outcomes and KT waitlist outcomes in this population from a single high-volume center.
Methods:
Patients from a single institution who received CABG for KT eligibility between August 2020 and May 2025 were retrospectively reviewed. Primary outcomes included all-cause mortality, occurrence of major adverse cardiovascular events, and incidence of subsequent KT.
Results:
Sixty patients received a CABG during KT evaluation with a median follow-up of 549 (interquartile range 244, 1039) d. Forty-five (75.0%) were males and the mean age was 59.6 (standard deviation [SD] 9.7) y. Patients were asymptomatic from coronary disease in 46 cases (76.7%) and the mean ejection fraction was 55.5% (SD 12.9). The mean Society of Thoracic Surgery score for predicted operative mortality was 2.9% (SD 2.6). All cause-mortality occurred in 2 (3.3%) at 30 d and 11 (18.3%) at 1 y. Postoperative major adverse cardiovascular events events at 1 y include stroke in 2 (3.3%), non-ST-elevation myocardial infarction in 7 (11.9%), and percutaneous coronary intervention in 4 (6.7%). Event-free 1-y survival was 69.3% (confidence interval 58.1-82.7). Ultimately, 11 (18.3%) received KT with the median time from CABG to KT of 564 d (interquartile range 404, 725).
Conclusions:
Despite considerable 30-d and 1-y mortality, a subset of patients undergoing CABG as a bridge to KT is ultimately able to receive KT following CABG. Further research is required to individualize preoperative decision-making.
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