Abstract 17044: Percutaneous Coronary Intervention and Dual Antiplatelet Therapy Are Safe Prior to Kidney Transplantation
Introduction: Kidney transplantation is the treatment of choice for eligible patients with end-stage renal disease. Perioperative cardiovascular morbidity and mortality are major determinants of surgical outcomes. A subset of this cohort may undergo coronary revascularization prior to transplant. The safety of preoperative PCI and DAPT has not previously been reported.
Methods: All patients who underwent kidney transplantat between 2008 and 2013 at the University of California Davis Medical Center were retrospectively identified. Patients who received coronary angiography with (PCI) and without (no-PCI) PCI prior to transplant were identified. Baseline demographics, angiographic findings, PCI characteristics, and in-hospital outcomes were analyzed.
Results: We identified 1312 patients who underwent kidney transplant during the study period. Sixty-three patients underwent pre-transplant coronary angiography with 22% (n=14) receiving PCI. The average number of days from angiography to KT was 6 (range 0-60). Baseline demographics and patient characteristics are described in Table 1. Table 2 depicts procedural, operative, and in-hospital outcomes. In the PCI cohort, 86% (n=12) received intervention to de-novo vs 14% (n=2) to in-stent restenosis lesions. In the PCI cohort, 71% (n=10) received drug-eluting stents while the remaining 29% (n=4) received bare metal stents. All patients who received PCI underwent transplant while on DAPT. There was no significant difference in intraoperative blood loss, transfusion requirement, or need for hemodialysis postoperatively in PCI vs no-PCI patients. There were no cases of acute stent thrombosis or perioperative MI.
Conclusions: In this ongoing analysis, PCI and DAPT prior to kidney transplantation did not adversely affect intraoperative or in-hospital outcomes. Updated results will be reported including perioperative (1 month) and long-term (1 year) rates of bleeding, MACE, and graft outcomes.
- Percutaneous coronary intervention (PCI)
- Organ preservation
- Interventional cardiology
- Heart catheterization
Author Disclosures: J. Malone: None. G. Singh: None. E. Armstrong: None. A. DeMattos: None. J. Laird: None. R. Low: None. M. Nishimura: None. J. Rogers: None. J. Southard: None. G. Wong: None.
- © 2014 by American Heart Association, Inc.