Acute coronary syndromes in the peri‐operative period after kidney transplantation in United States

Abstract

It is well known that chronic kidney disease (CKD) is an independent risk factor for the development of cardiovascular disease (CVD). 1 The risk of cardiovascular mortality goes up with progressive decline in estimated glomerular filtration rate (eGFR). 2,3 In fact, among patients with end-stage kidney disease (ESKD), there is up to a 30-fold increase in cardiovascular and all-cause mortality. 2,4 While kidney transplantation (KT) decreases the burden of cardiovascular disease (CVD) when compared to patients who remain on dialysis, the rates of major adverse cardiovascular events (MACE) are still higher compared to the general population. 5-7 In various prospective studies, the incidence of MACE after KT range from 5% to 20% and cardiovascular events can account for over 50% of all-cause mortality in KT recipients. 7-11 These adverse cardiovascular events may occur

Abdominal Organ Transplantation: Noteworthy Literature in 2020

“…Multivariate logistic regression identified age ≥65 years (OR = 4.84, 95% CI = 2.59-9.05, P < .001), African American race (OR = 0.66, 95% CI = 0.47-0.93, P = .02), known CAD (OR = 3.83, 95% CI = 2.84-5.15, P < .001), coagulopathy (OR = 2.15, 95% CI = 1.58-2.92, P < .001), electrolyte abnormalities (OR = 1.82, 95% CI = 1.43-2.32, P < .001), and weight loss (OR = 2.31, 95% CI = 1.28-4.18, P = .01), among others, as independent predictors of perioperative acute coronary syndrome. 45 In addition to CVD, kidney transplant recipients are at increased risk for cerebrovascular disease mortality. De La Mata's group identified the cause of death for 17 628 kidney transplant recipients from 1988 to 2012 in Australia and New Zealand using national registries.…”

“…Multivariate logistic regression identified age ≥65 years (OR = 4.84, 95% CI = 2.59-9.05, P < .001), African American race (OR = 0.66, 95% CI = 0.47-0.93, P = .02), known CAD (OR = 3.83, 95% CI = 2.84-5.15, P < .001), coagulopathy (OR = 2.15, 95% CI = 1.58-2.92, P < .001), electrolyte abnormalities (OR = 1.82, 95% CI = 1.43-2.32, P < .001), and weight loss (OR = 2.31, 95% CI = 1.28-4.18, P = .01), among others, as independent predictors of perioperative acute coronary syndrome. 45…”

Tacrolimus Concentration Is Effectively Predicted Using Combined Clinical and Genetic Factors in the Perioperative Period of Kidney Transplantation and Associated with Acute Rejection

“…The perioperative period, especially within 2 weeks after kidney transplantation, is the key time for renal function recovery. During this period, there may be various internal and surgical complications, hemodynamic instability, and pathophysiological manifestations [25][26][27], which has a strong impact on tacrolimus PK. Accordingly, we speculate that other clinical factors may explain residual tacrolimus PK variability in the early stage after kidney transplant.…”

Accuracy of administrative database estimates of national surgical volume: Solid organ transplantation in the National Inpatient Sample

“…Use of administrative datasets in medical research has proliferated, particularly the Healthcare Cost and Utilization Project's Nationwide Inpatient Sample and National Inpatient Sample (NIS) 1 . The NIS has been employed to investigate assorted research questions in solid organ transplantation 2–16 . Although validation of diagnosis codes has been performed in numerous contexts, 17 less is known about surgical procedure coding 18 .…”

“…1 The NIS has been employed to investigate assorted research questions in solid organ transplantation. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] Although validation of diagnosis codes has been performed in numerous contexts, 17 less is known about surgical procedure coding. 18 National solid organ transplantation volume is closely tracked and validated, providing a unique opportunity to investigate accuracy.…”