Belal AA, Santos Jr AH, Kazory A. Cardiac evaluation of renal transplant candidates with heart failure. World J Transplant 2024; 14(4): 96017 [DOI: 10.5500/wjt.v14.i4.96017]
Corresponding Author of This Article
Amer Ashaab Belal, FASN, MD, Doctor, Department of Medicine, Division of Nephrology, University of Florida College of Medicine, 1600 SW Archer RoadRoom CG-98, Communicore Building, Gainesville, FL 32610, United States. abelal@ufl.edu
Research Domain of This Article
Transplantation
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Transplant. Dec 18, 2024; 14(4): 96017 Published online Dec 18, 2024. doi: 10.5500/wjt.v14.i4.96017
Cardiac evaluation of renal transplant candidates with heart failure
Amer Ashaab Belal, Alfonso Hernandez Santos Jr, Amir Kazory
Amer Ashaab Belal, Department of Medicine, Division of Nephrology, University of Florida College of Medicine, Gainesville, FL 32610, United States
Alfonso Hernandez Santos Jr, Amir Kazory, Division of Nephrology, Hypertension and Renal Transplantation, University of Florida, Gainesville, FL 32608, United States
Author contributions: Belal A contributed to the writing of the original draft, literature review, critical revision and editing and approval of the final version of the manuscript; Santos Jr AH contributed to revision and approval of the final version of the manuscript; Kazory A contributed to the conception and design of the work, critical revision, editing, and approval of the final version of the manuscript.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: Https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Amer Ashaab Belal, FASN, MD, Doctor, Department of Medicine, Division of Nephrology, University of Florida College of Medicine, 1600 SW Archer RoadRoom CG-98, Communicore Building, Gainesville, FL 32610, United States. abelal@ufl.edu
Received: April 24, 2024 Revised: July 21, 2024 Accepted: July 24, 2024 Published online: December 18, 2024 Processing time: 148 Days and 15.7 Hours
Abstract
Patients with advanced kidney disease are at elevated risk of developing heart failure and appropriate risk stratification is important to permit them to receive kidney transplantation. The American Heart Association and American College of Cardiology joint statement provides guidance on risk stratification for the major cause of heart failure for these patients in its recommendations for coronary heart disease. Herein we provide an overview of the available literature on risk stratification for nonischemic heart failure and functional heart disease states such as pulmonary hypertension. Many of these options for optimizing these patients before transplant include optimizing their volume status, often with more aggressive ultrafiltration. Kidney transplantation remains the treatment of choice for patients with advanced kidney disease and cardiac disease, the correction of the azotemic substances with kidney transplantation has been associated with improved survival than remaining on dialysis long-term. The findings in the studies reviewed here are expected to help clinicians refine current strategies for evaluating potential kidney transplant recipients.
Core Tip: There are several reviews in the literature detailing the risk stratification for patients undergoing kidney transplant evaluation for coronary heart disease. However, there are relatively few reviews that detail the means to optimize patients with heart failure. This review seeks to report on the latest recommendations to permit efficient and appropriate cardiac evaluation and stratification for patients with advanced kidney disease undergoing evaluation for a kidney transplant as well as review the pathophysiology underlying their unique disease state to inform pretransplant therapeutic options.
