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dc.contributor.authorWong, C F
dc.contributor.authorLittle, M A
dc.contributor.authorVinjamuri, S
dc.contributor.authorHammad, A
dc.contributor.authorHarper, J M
dc.date.accessioned2012-11-29T14:52:51Z
dc.date.available2012-11-29T14:52:51Z
dc.date.issued2008-06
dc.identifier.citationTechnetium myocardial perfusion scanning in prerenal transplant evaluation in the United kingdom. 2008, 40 (5):1324-8 Transplant. Proc.en_GB
dc.identifier.issn0041-1345
dc.identifier.pmid18589097
dc.identifier.doi10.1016/j.transproceed.2008.03.143
dc.identifier.urihttp://hdl.handle.net/10147/253938
dc.description.abstractBecause death with a functioning graft remains one of the most important causes of long-term renal transplant failure, cardiac risk stratification and screening for coronary artery disease are essential components of pretransplant assessment. Pretransplant screening for occult coronary artery disease in a subset of these patients may improve outcome. The UK follows the European Best practice guideline 1.5.5 E. Although echocardiography, thallium myocardial perfusion scanning (MPS), dobutamine stress echocardiography, and coronary angiography have been suggested as means of cardiovascular assessment, the best means of assessment remains undetermined. Therefore, we investigated the role of 99m technetium sestamibi myocardial perfusion scanning as an assessment tool for identifying those patients with end-stage renal failure at high risk of cardiovascular death after renal transplantation. Retrospectively, we studied 126 patients that had a MPS as part of their pretransplant assessment. Overall unadjusted survival was 65% at 3 years. Twelve deaths resulted from cardiovascular causes. A reversible defect on MPS was associated with a fatal cardiac event and all-cause mortality. The unadjusted hazard ratio of cardiac event with reversible defect on MPS was 3.1 (95% confidence interval, 1.1 to 18.2) and hazard ratio of death with reversible defect on MPS was 1.92 (95% confidence interval, 1.1 to 4.4). Thus, MPS may be a useful tool in cardiac risk stratification and in selecting patients with a favorable outcome after renal transplantation. Our patients with a reversible defect in particular have increased cardiac mortality. This group may benefit from coronary angiography.
dc.language.isoenen
dc.publisherTransplantation proceedingsen_GB
dc.rightsArchived with thanks to Transplantation proceedingsen_GB
dc.subject.meshCoronary Angiography
dc.subject.meshCoronary Disease
dc.subject.meshDobutamine
dc.subject.meshExercise Test
dc.subject.meshFemale
dc.subject.meshGreat Britain
dc.subject.meshHeart
dc.subject.meshHeart Diseases
dc.subject.meshHumans
dc.subject.meshKidney Transplantation
dc.subject.meshMale
dc.subject.meshMiddle Aged
dc.subject.meshPreoperative Care
dc.subject.meshRisk Assessment
dc.subject.meshTechnetium Tc 99m Sestamibi
dc.subject.meshTomography, Emission-Computed, Single-Photon
dc.titleTechnetium myocardial perfusion scanning in prerenal transplant evaluation in the United kingdom.en_GB
dc.typeArticleen
dc.contributor.departmentDepartment of Nephrology and Transplantation, Royal Liverpool University Hospital, Liverpool, United Kingdom. chriswong@doctors.org.uken_GB
dc.identifier.journalTransplantation proceedingsen_GB
dc.description.provinceLeinsteren
html.description.abstractBecause death with a functioning graft remains one of the most important causes of long-term renal transplant failure, cardiac risk stratification and screening for coronary artery disease are essential components of pretransplant assessment. Pretransplant screening for occult coronary artery disease in a subset of these patients may improve outcome. The UK follows the European Best practice guideline 1.5.5 E. Although echocardiography, thallium myocardial perfusion scanning (MPS), dobutamine stress echocardiography, and coronary angiography have been suggested as means of cardiovascular assessment, the best means of assessment remains undetermined. Therefore, we investigated the role of 99m technetium sestamibi myocardial perfusion scanning as an assessment tool for identifying those patients with end-stage renal failure at high risk of cardiovascular death after renal transplantation. Retrospectively, we studied 126 patients that had a MPS as part of their pretransplant assessment. Overall unadjusted survival was 65% at 3 years. Twelve deaths resulted from cardiovascular causes. A reversible defect on MPS was associated with a fatal cardiac event and all-cause mortality. The unadjusted hazard ratio of cardiac event with reversible defect on MPS was 3.1 (95% confidence interval, 1.1 to 18.2) and hazard ratio of death with reversible defect on MPS was 1.92 (95% confidence interval, 1.1 to 4.4). Thus, MPS may be a useful tool in cardiac risk stratification and in selecting patients with a favorable outcome after renal transplantation. Our patients with a reversible defect in particular have increased cardiac mortality. This group may benefit from coronary angiography.


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