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Role of a cardio‐renal multi‐disciplinary team meeting in managing cardiovascular risk in patients on kidney transplant waitlists

Junarta, J; Fernandez, M; Chung, I; Salha, A; Klaud Francheska, BD; Lowe-Jones, R; Sharma, R; Firoozi, S; Banerjee, D (2020) Role of a cardio‐renal multi‐disciplinary team meeting in managing cardiovascular risk in patients on kidney transplant waitlists. Clin Transplant, 34 (11). e14061. ISSN 1399-0012 https://doi.org/10.1111/ctr.14061
SGUL Authors: Banerjee, Debasish

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Abstract

Background Waitlisted kidney transplant patients suffer from excess cardiovascular events. The benefits of regular cardiac investigations, potentially harmful and expensive, are unknown. We investigate the effectiveness of a cardio‐renal MDT in managing high cardiovascular risk waitlisted transplant patients to prevent events and enable transplantation. Methods Clinical outcomes in waitlisted transplant candidates managed by our cardio‐renal MDT protocol were compared against our standard protocol. Data compared include the transplantation, event, and death rates, cost of cardiac investigations and procedures, and graft, patient survival, and re‐hospitalization rates in transplanted patients. Results 207 patients were studied (81 standard, 126 cardio‐renal MDT). Over 2.7 years, the cardio‐renal MDT protocol transplanted more patients than the standard group (35% vs 21%; P = .02). The managing cost per patient per year was higher in the standard group (£692 vs £610). This was driven by more echocardiograms and more tests per patient in the standard group (P < .01). There was no difference in adverse events or death. There was no difference in re‐hospitalization, graft or patient survival rate in transplanted patients. Conclusions Our cardio‐renal MDT was effective in managing high‐risk kidney transplant candidates with greater rates of transplantation and low rates of events at a lower cost.

Item Type: Article
Additional Information: © 2020 The Authors. Clinical Transplantation published by John Wiley & Sons Ltd This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
Keywords: cardio-renal syndrome, cardiovascular disease, chronic kidney disease, end-stage renal disease, kidney transplantation, cardio-renal syndrome, cardiovascular disease, chronic kidney disease, end-stage renal disease, kidney transplantation, Surgery, 1103 Clinical Sciences
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: Clin Transplant
ISSN: 1399-0012
Language: eng
Dates:
DateEvent
19 November 2020Published
27 August 2020Published Online
3 August 2020Accepted
Publisher License: Creative Commons: Attribution-Noncommercial-No Derivative Works 4.0
PubMed ID: 32780546
Web of Science ID: WOS:000563337000001
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/112273
Publisher's version: https://doi.org/10.1111/ctr.14061

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