Evaluation of the Cardiovascular Prior to Transplantation; An Endless Debate

Although renal transplantation reduces cardiovascular morbidity and mortality compared to end stage renal disease (ESRD), it is associated with an early increase of cardiovascular morbidity and mortality [1-9]. Renal transplantation recipients should undergo rigorous screening processes considering not only peri-operative risk, but also must be designed to provide information regarding CV risk in the early years posttransplantation [10,11]. There is no universally accepted screening process especially in asymptomatic chronic kidney disease (CKD) patients given their high cardiac risk even if asymptomatic [8,1227]. All recipients must be tested by non-invasive methods as recommended by Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines and the only determinant for testing by American College of Cardiology/American Heart Association (ACR/AHA) guidelines were functional status tempered by risk factor profile [18,19].