A Report of the Lisbon Conference on the Care of the Kidney Transplant Recipient

Diagnosis and Management of Cardiovascular Disease in Advanced and End‐Stage Renal Disease

“…Instead, the 2012 AHA/ACC scientific statement regarding cardiac evaluation in renal transplantation candidates recommends that the decision to proceed with noninvasive stress testing in patients with no active cardiac conditions should be based on the presence of multiple risk factors for CAD most relevant to the transplantation population, regardless of functional status. These risk factors include diabetes mellitus, prior cardiovascular disease, >1 year on dialysis, left ventricular hypertrophy (LVH), age >60 years, smoking, hypertension, and dyslipidemia 20, 22. Although the specific number of risk factors to proceed with stress testing remains to be determined, the AHA/ACC guidelines suggest the presence of ≥3 risk factors as a reasonable threshold for noninvasive testing 20.…”

Medical Management of the Kidney Transplant Recipient

“…Secondary causes should be excluded: pulmonary disease, erythroleukemia, renal cancer, and hepatitis B or C (2). It is recommended that the hemoglobin be maintained at <17.5 g/dl by ACE inhibitors or ARB even if the patient is normotensive (2,60). Phlebotomy is used for patients with PTE who do not respond to treatment with an ARB or ACE inhibitor (60,61).…”

“…It is recommended that the hemoglobin be maintained at <17.5 g/dl by ACE inhibitors or ARB even if the patient is normotensive (2,60). Phlebotomy is used for patients with PTE who do not respond to treatment with an ARB or ACE inhibitor (60,61). It is also used in conjunction with ACE inhibitors or ARBs for patients who present with hemoglobin greater than 18.5 gm/dL (60,61).…”

“…Phlebotomy is used for patients with PTE who do not respond to treatment with an ARB or ACE inhibitor (60,61). It is also used in conjunction with ACE inhibitors or ARBs for patients who present with hemoglobin greater than 18.5 gm/dL (60,61). Relapse of PTE is common if therapy is discontinued (2, 60).…”

Anesthesia for Kidney Transplantation-A Review

“…These risk factors include diabetes mellitus, prior cardiovascular disease, and duration of dialysis greater than 1 year, left ventricular hypertrophy, age greater than 60 years, smoking, hypertension, or dyslipidemia. The risk factors were deemed relevant to transplantation candidates and were adapted at the 2007 Lisbon Conference [15]. The type of noninvasive testing used for further risk stratification (dobutamine stress echocardiography versus myocardial perfusion scintigraphy), is at the discretion of the perioperative evaluator.…”