Technetium myocardial perfusion scanning in prerenal transplant evaluation in the United kingdom.

Hdl Handle:
http://hdl.handle.net/10147/253938
Title:
Technetium myocardial perfusion scanning in prerenal transplant evaluation in the United kingdom.
Authors:
Wong, C F; Little, M A; Vinjamuri, S; Hammad, A; Harper, J M
Affiliation:
Department of Nephrology and Transplantation, Royal Liverpool University Hospital, Liverpool, United Kingdom. chriswong@doctors.org.uk
Citation:
Technetium myocardial perfusion scanning in prerenal transplant evaluation in the United kingdom. 2008, 40 (5):1324-8 Transplant. Proc.
Publisher:
Transplantation proceedings
Journal:
Transplantation proceedings
Issue Date:
Jun-2008
URI:
http://hdl.handle.net/10147/253938
DOI:
10.1016/j.transproceed.2008.03.143
PubMed ID:
18589097
Abstract:
Because death with a functioning graft remains one of the most important causes of long-term renal transplant failure, cardiac risk stratification and screening for coronary artery disease are essential components of pretransplant assessment. Pretransplant screening for occult coronary artery disease in a subset of these patients may improve outcome. The UK follows the European Best practice guideline 1.5.5 E. Although echocardiography, thallium myocardial perfusion scanning (MPS), dobutamine stress echocardiography, and coronary angiography have been suggested as means of cardiovascular assessment, the best means of assessment remains undetermined. Therefore, we investigated the role of 99m technetium sestamibi myocardial perfusion scanning as an assessment tool for identifying those patients with end-stage renal failure at high risk of cardiovascular death after renal transplantation. Retrospectively, we studied 126 patients that had a MPS as part of their pretransplant assessment. Overall unadjusted survival was 65% at 3 years. Twelve deaths resulted from cardiovascular causes. A reversible defect on MPS was associated with a fatal cardiac event and all-cause mortality. The unadjusted hazard ratio of cardiac event with reversible defect on MPS was 3.1 (95% confidence interval, 1.1 to 18.2) and hazard ratio of death with reversible defect on MPS was 1.92 (95% confidence interval, 1.1 to 4.4). Thus, MPS may be a useful tool in cardiac risk stratification and in selecting patients with a favorable outcome after renal transplantation. Our patients with a reversible defect in particular have increased cardiac mortality. This group may benefit from coronary angiography.
Item Type:
Article
Language:
en
MeSH:
Coronary Angiography; Coronary Disease; Dobutamine; Exercise Test; Female; Great Britain; Heart; Heart Diseases; Humans; Kidney Transplantation; Male; Middle Aged; Preoperative Care; Risk Assessment; Technetium Tc 99m Sestamibi; Tomography, Emission-Computed, Single-Photon
ISSN:
0041-1345

Full metadata record

DC FieldValue Language
dc.contributor.authorWong, C Fen_GB
dc.contributor.authorLittle, M Aen_GB
dc.contributor.authorVinjamuri, Sen_GB
dc.contributor.authorHammad, Aen_GB
dc.contributor.authorHarper, J Men_GB
dc.date.accessioned2012-11-29T14:52:51Z-
dc.date.available2012-11-29T14:52:51Z-
dc.date.issued2008-06-
dc.identifier.citationTechnetium myocardial perfusion scanning in prerenal transplant evaluation in the United kingdom. 2008, 40 (5):1324-8 Transplant. Proc.en_GB
dc.identifier.issn0041-1345-
dc.identifier.pmid18589097-
dc.identifier.doi10.1016/j.transproceed.2008.03.143-
dc.identifier.urihttp://hdl.handle.net/10147/253938-
dc.description.abstractBecause death with a functioning graft remains one of the most important causes of long-term renal transplant failure, cardiac risk stratification and screening for coronary artery disease are essential components of pretransplant assessment. Pretransplant screening for occult coronary artery disease in a subset of these patients may improve outcome. The UK follows the European Best practice guideline 1.5.5 E. Although echocardiography, thallium myocardial perfusion scanning (MPS), dobutamine stress echocardiography, and coronary angiography have been suggested as means of cardiovascular assessment, the best means of assessment remains undetermined. Therefore, we investigated the role of 99m technetium sestamibi myocardial perfusion scanning as an assessment tool for identifying those patients with end-stage renal failure at high risk of cardiovascular death after renal transplantation. Retrospectively, we studied 126 patients that had a MPS as part of their pretransplant assessment. Overall unadjusted survival was 65% at 3 years. Twelve deaths resulted from cardiovascular causes. A reversible defect on MPS was associated with a fatal cardiac event and all-cause mortality. The unadjusted hazard ratio of cardiac event with reversible defect on MPS was 3.1 (95% confidence interval, 1.1 to 18.2) and hazard ratio of death with reversible defect on MPS was 1.92 (95% confidence interval, 1.1 to 4.4). Thus, MPS may be a useful tool in cardiac risk stratification and in selecting patients with a favorable outcome after renal transplantation. Our patients with a reversible defect in particular have increased cardiac mortality. This group may benefit from coronary angiography.en_GB
dc.language.isoenen
dc.publisherTransplantation proceedingsen_GB
dc.rightsArchived with thanks to Transplantation proceedingsen_GB
dc.subject.meshCoronary Angiography-
dc.subject.meshCoronary Disease-
dc.subject.meshDobutamine-
dc.subject.meshExercise Test-
dc.subject.meshFemale-
dc.subject.meshGreat Britain-
dc.subject.meshHeart-
dc.subject.meshHeart Diseases-
dc.subject.meshHumans-
dc.subject.meshKidney Transplantation-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshPreoperative Care-
dc.subject.meshRisk Assessment-
dc.subject.meshTechnetium Tc 99m Sestamibi-
dc.subject.meshTomography, Emission-Computed, Single-Photon-
dc.titleTechnetium myocardial perfusion scanning in prerenal transplant evaluation in the United kingdom.en_GB
dc.typeArticleen
dc.contributor.departmentDepartment of Nephrology and Transplantation, Royal Liverpool University Hospital, Liverpool, United Kingdom. chriswong@doctors.org.uken_GB
dc.identifier.journalTransplantation proceedingsen_GB
dc.description.provinceLeinsteren

Related articles on PubMed

All Items in Lenus, The Irish Health Repository are protected by copyright, with all rights reserved, unless otherwise indicated.