*Purpose: Renal transplant patients have higher cardiovascular (CV) risk compared to their peers. Pre-transplant CV risk factors may be amplified post-transplant, but little is known about their impact on graft outcomes. We hypothesized that patients with higher pre-transplant CV risk are more likely to have graft failure.

*Methods: This retrospective cohort study evaluated CV risk in first time renal transplant recipients from 2010 to 2015 receiving alemtuzumab induction. CV risk for patients with no prior ASCVD was determined by 10-year atherosclerotic cardiovascular disease (ASCVD) risk score using the pooled cohort equations and categorized into high (ASCVD risk score &gt 20%), intermediate (7.5-20%), and low risk (&lt 7.5%) groups. Primary outcomes were graft failure and glomerular filtration rate (GFR). Secondary outcomes included major adverse cardiovascular events (MACE), biopsy-proven acute rejection (BPAR), patient death, and CV-related death. Chi-square, Fischer exact test, Student’s t-test, one-way ANOVA, and linear regression were used as appropriate.

*Results: Of 297 screened patients, 144 met inclusion criteria. Of the included patients, 88 (61%) patients had a pre-transplant history of ASCVD while 56 (39%) did not. Of the 56 patients with no prior ASCVD, 10 (18%), 21 (38%), and 25 (45%) patients were high, intermediate, and low risk, respectively. Table 1 compared patient factors. Between patients with and without prior ASCVD or between risk groups, no differences in graft failure (Figure 1), GFR (Figure 2), MACE, BPAR (Figure 3), patient death or CV-related death (Figure 4) were observed.

*Conclusions: We did not find any differences in transplant outcomes based on pre-transplant CV risk. Interestingly, none of the high risk ASCVD patients experienced graft failure or demonstrated a higher rate of early CV rates, despite the known perioperative CV risks of surgery. Limitations included the retrospective design, small sample size, and exclusion of a large portion of patients without prior ASCVD events. Larger studies are needed to evaluate if ASCVD risk score does not correlate with graft failure.

« Back to 2020 American Transplant Congress