Risk of post-transplant cardiovascular events in kidney transplant recipients with preexisting aortoiliac stenosis

Shabnam Babakry, Elsaline Rijkse, Joke I. Roodnat, Diederik C. Bijdevaate, Jan N.M. IJzermans, Robert C. Minnee*

*Corresponding author for this work

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Prediction of the risk of cardiovascular events (CVE's) is important to optimize outcomes after kidney transplantation. Aortoiliac stenosis is frequently observed during pre-transplant screening. We hypothesized that these patients are at higher risk of post-transplant CVE's due to the joint underlying atherosclerotic disease. Therefore, we aimed to assess whether aortoiliac stenosis was associated with post-transplant CVE's. This retrospective, single-center cohort study included adult kidney transplant recipients, transplanted between 2000 and 2016, with contrast-enhanced imaging available. Aortoiliac stenosis was classified according to the Trans-Atlantic Inter-Society Consensus (TASC) II classification and was defined as significant in case of ≥50% lumen narrowing. The primary outcome was CVE-free survival. Eighty-nine of 367 patients had significant aortoiliac stenosis and were found to have worse CVE-free survival (median CVE-free survival: stenosis 4.5 years (95% confidence interval (CI) 2.8–6.2), controls 8.9 years (95% CI 6.8–11.0); log-rank test P <.001). TASC II C and D lesions were independent risk factors for a post-transplant CVE with a hazard ratio of 2.15 (95% CI 1.05–4.38) and 6.56 (95% CI 2.74–15.70), respectively. Thus, kidney transplant recipients with TASC II C and D aortoiliac stenosis require extensive cardiovascular risk management pre-, peri,- and post-transplantation.

Original languageEnglish
Article numbere14515
JournalClinical Transplantation
Issue number1
Early online date21 Oct 2021
Publication statusPublished - Jan 2022

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© 2021 The Authors. Clinical Transplantation published by John Wiley & Sons Ltd.


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