Screening Transplant Waitlist Candidates for Coronary Artery Disease

Living donor transplantation is associated with the lowest risk of peri-operative death. The figure shows the multivariable-adjusted relative risks of death in patients ≥65 years of age with low (left panel), intermediate (center panel), and high (right panel) cardiovascular risk. In each panel, the multivariable-adjusted risk of death in living donor (LD; shown in red), standard criteria deceased donor/low kidney donor profile index (SCD; shown in purple), or expanded criteria deceased donor/high kidney donor profile index (ECD; shown in green) transplant recipients is compared with that in waitlisted patients (WL) of similar cardiovascular risk (shown in blue) who had been on dialysis for equal lengths of time but who had not yet received a kidney transplant. The accompanying table shows the time to equalize the risk of death and survival in transplant recipients compared with patients who remained waitlisted. The times to equal risk and equal survival were far lower for patients who received an LD transplant. KDPI, kidney donor profile index; TX, transplantation. Modified from reference 5, with permission.