Abstract: SA-PO1080
A Second Opinion: The Role of Cardiac Revascularization in Kidney Transplant Candidates
Session Information
- Transplantation: Clinical - Postkidney Transplant Outcomes and Potpourri
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Iyer, Sudhanvan, The University of Texas Medical Branch John Sealy School of Medicine, Galveston, Texas, United States
- Shirafkan, Ali, The University of Texas Medical Branch John Sealy School of Medicine, Galveston, Texas, United States
- Nguyen, Philong, The University of Texas Medical Branch John Sealy School of Medicine, Galveston, Texas, United States
- Wang, Joshua, The University of Texas Medical Branch John Sealy School of Medicine, Galveston, Texas, United States
- Rastellini, Cristiana, The University of Texas Medical Branch John Sealy School of Medicine, Galveston, Texas, United States
- Golovko, George, The University of Texas Medical Branch John Sealy School of Medicine, Galveston, Texas, United States
- Cicalese, Luca, The University of Texas Medical Branch John Sealy School of Medicine, Galveston, Texas, United States
Background
Pre-kidney transplant (KTX) cardiac risk stratification currently relies on protocols developed for non-transplant end-stage renal disease (ESRD) populations and a positive stress test (+ST) is often not followed by cardiac catheterization (CC). We investigated whether patients who receive CC after +ST and +/- revascularization improve survival and transplant outcomes.
Methods
Using the TriNetX Research Network, we identified adults who underwent KTX (2004–2024) and had a +ST within five years prior. +ST patients were grouped by whether they received CC (n=11,171) or not (n=47,833) and whether those with CC had following revascularization (n = 2,891) or not (n=8,280). Propensity score matching by demographic and cardiovascular factors yielded 2,853 patients per group. Primary outcomes were one-year mortality and five-year transplant complications.Using the TriNetX Research Network, we identified adults who underwent KTX (2004–2024) and had a +ST within five years prior. +ST patients were grouped by whether they received CC (n=11,171) or not (n=47,833) and whether those with CC had following revascularization (n = 2,891) or not (n=8,280). Propensity score matching by demographic and cardiovascular factors yielded 2,853 patients per group. Primary outcomes were one-year mortality and five-year transplant complications.
Results
Among propensity matched KTX recipients, those who underwent CC with subsequent revascularization experienced significantly lower one-year mortality (RR, 1.446; 95% CI, 1.034-2.062) and five-year kidney transplant complications (RR: 0.847; 95% CI, (0.782-0.916) compared to those who did not. This suggests a potential benefit of CC following +ST and revascularization in optimizing patient survival and early post-transplant outcomes.
Conclusion
In our cohort, patients who underwent +ST evaluation with subsequent revascularization exhibited the highest survival rates.These data suggest that during pre-KTX evaluation, CC should routinely follow a +ST, and revascularization should be pursued when indicated. This approach is associated with the best survival in this patient population.
Funding
- Other NIH Support