Cardiac Disease Evaluation and Management Among Kidney and Liver Transplantation Candidates

  • Lentine K
  • Costa S
  • Weir M
  • et al.
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Abstract

A. Eagle, MD, FAHA, Chair; on behalf of the American Heart Association Council on the Kidney in Cardiovascular Disease and Council on Peripheral Vascular Disease T he challenges inherent in conducting accurate, clin-ically effective, and cost-effective cardiac evalua-tions among transplantation candidates relate to the large size of the target population, the prevalence of disease, the limited number of donated organs, and the often extended waiting periods between initial evaluation and transplantation surgery. According to Organ Procurement and Transplant Network (OPTN) records, nearly 85,000 candidates were on the waiting list for kidney transplantation in 2010, and Ϸ17,700 kidney transplantations (including 828 kidney-pancreas transplantations) were performed (1). Also in 2010, 16,000 people were awaiting liver transplantation and 6,000 received liver allografts (1). Marked shifts in the age compo-sition of transplant waitlists toward older adults are also raising the average medical complexity and comorbidity burden among listed candidates. In 2011, 62% of kidney transplantation candidates were Ն50 years of age compared with 28.7% of kidney transplantation candidates in 1991 (1). A similar shift in age distribution has occurred among liver transplantation candidates; now, 77% are Ն50 years of age (1). Cardiovascular disease is a leading cause of morbidity and mortality among patients with end-stage failure of

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Lentine, K. L., Costa, S. P., Weir, M. R., Robb, J. F., Fleisher, L. A., Kasiske, B. L., … Eagle, K. A. (2012). Cardiac Disease Evaluation and Management Among Kidney and Liver Transplantation Candidates. Circulation, 126(5), 617–663. https://doi.org/10.1161/cir.0b013e31823eb07a

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