CRCM  Vol.3 No.4 , April 2014
Noninvasive Cardiac Testing—A New Routine in Evaluation of Renal Transplant Candidates
ABSTRACT

We report a case of a young kidney transplant candidate presented with severe and clinically completely asymptomatic mitral stenosis. The bedside Echocardiogram was helpful to establish the diagnosis. The surgery had to be postponed and the patient was referred to a cardiologist for the further workup. This case report provides solid evidence that the renal transplant candidates are a very unique group of patients with specific disease development course. Their preoperative workup cannot be based on widely used guidelines from American College of Cardiology and American Heart Association that are relying on clinical symptoms and presentation of cardiac disease. All physicians who are involved in the care of these patients and making decisions about their candidacy for the transplantation should take into account severity and very often asymptomatic presentation of the cardiovascular complications of the end stage renal disease. This case provides a good example of the importance of the multispecialty involvement and coordination in perioperative care for prospective kidney transplant candidates.


Cite this paper
Moguilevitch, M. and Delphin, E. (2014) Noninvasive Cardiac Testing—A New Routine in Evaluation of Renal Transplant Candidates. Case Reports in Clinical Medicine, 3, 240-243. doi: 10.4236/crcm.2014.34055.
References
[1]   Port, F.K., Merion, R.M., Finley, M.P., et al. (2007) Trends in Organ Donation and Transplantation in the United States, 1996-2005. American Journal of Transplantation, 7, 1319-1326.
http://dx.doi.org/10.1111/j.1600-6143.2007.01778.x

[2]   Health Resources and Services Administration (2011) Organ Procurement and Transplant Network Database.
http://optn.transplant.hrsa.gov/

[3]   Foley, R.N., Parfrey, P.S. and Sarnak, M.J. (1998) Clinical Epidemiology of Cardiovascular Disease in Chronic Renal Disease. American Journal of Kidney Disease, 32, S112.
http://dx.doi.org/10.1053/ajkd.1998.v32.pm9820470

[4]   Sato, K., Tadokoro, F., Ishida, K., Matsuzawa, K. and Nakayama, Y. (1994) Causes of Death after Renal Transplantation. A Long Term Follow-Up Study. Transplant Proceedings, 26, 2017-2018.

[5]   Rostand, R.G., Kirk, K.A. and Rutsky, E.A. (1984) Dialysis Ischemic Heart Disease. Insight from Coronary Angiography. Kidney International Journal, 25, 653-659.
http://dx.doi.org/10.1038/ki.1984.70

[6]   Umana, E., Ahmed, W. and Alpert, M.A. (2003) Valvular and Perivalvular Abnormalities in End-Stage Renal Disease. American Journal of Medical Science, 325, 237-242.
http://dx.doi.org/10.1097/00000441-200304000-00010

[7]   Mizutani, K., Naruko, T., Komatsu, R. and Ueda, M. (2011) Enhanced Expression of Neopterin in Accumulated Macrophages at Aortic Valve Stenosis in Patients with Hemodialysis. Journal of American College of Cardiology, 57, E1303.
http://dx.doi.org/10.1016/S0735-1097(11)61303-X

[8]   Lentine, K.L., Costa, S.P., Weir, M.R., Robb, J.F., Fleisher, L.A., Kasiske, B.L. and Carithers, R.L. (2012) Cardiac Disease Evaluation and Management among Kidney and Liver Transplantation Candidates. A Scientific Statement from AHA/ACCF. Circulation, 126, 1-47.

[9]   Bonow, R.O., Carabello, B.A. and Chatterjee, K. (2008) Focused Update Incorporated into the ACC/AHA 2006 Guidelines for the Management of Patients with Valvular Heart Disease: A Report of ACC/AHA Task Force on Practice Guidelines. Circulation, 118, e523-e661.

[10]   Abbott, K.C., Hshieh, P. and Cruess, D. (2003) Hospitalized Valvular Heart Disease in Patients on Renal Transplant Waitlist: Incidence, Clinical Correlates and Outcomes. Clinical Nephrology, 59, 79-87.
http://dx.doi.org/10.5414/CNP59079

[11]   Sharma, A., Gilbertson, D.T. and Herzog, C.A. (2010) Survival of Kidney Transplantation Patients in the United States after Cardiac Valve Replacement. Circulation, 121, 2733-2739.
http://dx.doi.org/10.1161/CIRCULATIONAHA.109.912170

[12]   Shirali, A.C. and Bia, M.J. (2008) Management of Cardiovascular Disease in Renal Transplant Recipients. Clinical Journal American Society of Nephrology, 3, 491.
http://dx.doi.org/10.2215/CJN.05081107

 
 
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